Credentialing is a service that we provide to physicians who are looking to become par providers with insurance companies.
In some cases, it is profitable for a provider not to participate with a particular insurance company. In these cases the provider is considered to be "out-of-network" with that insurance comapany and depending on the situation may actually receive a higher pay rate than a doctor who is participating with the company.
HOWEVER, in other situations, it is imperative that the phisician become participating with the insurance companies because otherwise they may not exact payment AT ALL. In these cases, our services are offered to fill out the applications, submit all necessary documentation, and follow up on the application until it gets approved. In some cases, the application is submitted but the quota with the insurance company for your specialty of provider is full. We then keep the application on file until such time as we are notified that the pannel has opened up, and we petition the company for par status again. We repeat this process until the application is approved.
If you are unsure with which insurance companies it is more profitable to be a par provider - contact one of our billers and we would be more than happy to evaluate your situation and advise you on the matter.