Credentialing

Medical credentialing is a quality assurance mechanism that guarantees that healthcare professionals meet the standards set by regulatory bodies and accrediting organizations and it safeguards patient safety and maintains the integrity of healthcare delivery systems. Medical organizations, government agencies and insurance companies validate credentials of healthcare providers including their education, proper licensing, professional training & certifications, malpractice, and required skills to provide standard healthcare services to patients. If healthcare providers’ credentialing is handled by a real expert, then they become eligible to participate in various insurance networks and receive proper reimbursement for the medical services they offer to patients. Insurance companies don’t pay to providers that are not properly credentialed with them and have a valid contract.

Why Medventure Connect?

  • Comprehensive verification of all the required information and documents including provider’s personal details, medical license, professional certifications, trainings, education background, work experience, and malpractice history.

  • Quality assurance check on all the filled application before submission.
  • Checking and confirming application status after submission.

  • Ongoing monitoring of application status.

  • Regular follow up with insurances to make sure application is approved in a timely manner.

  • Sharing detailed reports with updates on application status with providers every week.

  • Working closely with insurance contractors to get best possible fee schedules.

Our credentialing service covers

  • NPI registry
  • CAQH registration
  • CAQH maintenance
  • Medicare enrolment
  • Medicaid enrolment
  • Commercial insurances enrolment in all states
  • Contract negotiation
  • Revalidation
  • CLIA Registration
  • Providers state license

Documents Checklist

  • Healthcare providers License
  • Malpractice (professional liability insurance)
  • IRS letter
  • W-9
  • Valid driver’s license
  • Board Certifications
  • Highest education diploma
  • Updated CV
  • DEA certificate
  • CLIA Certificate (If required)
  • Business License
  • Bank account verification letter
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