Cosmos Curbs Provider Credentialing in 6 Key Steps

When an organization hires a new physician, a nurse or a practitioner it is essential for them to verify the new appointees through the physician credentialing process also known as medical credentialing process. This allows you to verify their qualification and skills. This also lets your preferred insurance companies to assess their skills and gets the physicians listed as a medically approved provider by them. Every healthcare provider has to reapply each time when they switch employers even though they have been approved by insurance panels in the past. 

Physician Credentialing services are unfortunately a time-consuming process. It also involves a lot of your Organization’s resources and expenditure. To make the physician credentialing process more transparent, experts at COSMOS have curbed the entire process to 6 steps. 

There are different physician credentialing services process for different healthcare providers. Although this process is essential for doctors and physicians, insurance credentialing services is also very important for:

• Psychologists and counselors
• Therapists
• Dental Practitioners
• Licensed massage specialists
• Hospitals and health agencies

Before accepting Medicare and Medicaid, your organization or clinic needs to ensure that their credentialing department meets all the guidelines from the federal agencies like:

• The Joint Commission on Accreditation of Healthcare Organizations
• Centers for Medicare & Medicaid Services (CMS)

Apart from these federal regulations, each state has its own requirements to be fulfilled for credentialing requirements.

To make sure your healthcare providers complete their physician credentialing process on time, follow these steps Cosmos has come up with.

1. Identify the required process

Every insurer goes through a unique documentation procedure when you begin with credentialing process. You need to submit the complete applications to each insurer as even one missed piece of information may delay your approval. 

2. Prioritize Insurers

Prioritizing and submitting your applications will prove to be advantageous when you have multiple forms to submit. 

3. Check for Accurate Information

Maintaining the quality and accuracy of your information on the documents is the key to complete your credentialing process work faster. 

4. Wait for Verification

Waiting for your approval after submitting all your documents to your insurers can be a lengthy process. Just give yourself the maximum time of 150 days before getting anxious about it. 

5. Regular Follow Up

A consistent follow- up is a necessary step once you are in the waiting phase. After step 4 don’t just wait five or six months to hear from an insurer, instead keep track of your credentialing by getting back to them timely.

6. Recertification

Once certified it doesn’t mean you are certified forever. Eventually your healthcare provider will receive the credentialing, but still they may need to get re-certified after a set interval of time. 

Cosmos, as a medical and laboratory credentialing service provider has been making life easier for the health care providers by providing their services to individual and organizations. 

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