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Credentialing Service

Our credentialing Service is a crucial step in avoiding late healthcare claim submission, exceeding filing limits, wasting time, and losing revenue. Our experienced team manages the credentialing process and assists you with provider enrollment and medical credentialing.

We ensure that the credentials received from the practitioner are completely accurate and review them on a regular basis for additional verification.

Credentialing service as a team

A team that completes credentialing details and submits them to commercial insurance companies, medicare, and medicaid as requested by healthcare providers.

Optimedserivces ensure compliance

Our credentialing services ensure compliance with the NCQA and the Department of Health and Family Services (DHFS).

Contracting problems and data integrity

Through audits, we resolve contracting issues and ensure data integrity.

  • Medical credentialing services typically entail gathering information about a physician’s background and qualifications via a formal application that is cross-checked against reliable sources such as the National Practitioner Data Bank or the American Board of Medical Specialties.

     

  • For about 5 years, the coalition for affordable quality healthcare has offered a credentialing services , which has been adopted by the majority of payers in the United States.

     

  • Physicians are typically required to answer 800 questions when contacted by a hospital, HMO, or employer. Items ranging from licensure to practice history in the last five years are included in the information.

Finding the best medical billing company and credentialing services

The best medical billing company and credentialing services can be a difficult task for a healthcare professional. The service provider a medical professional selects will determine whether there will be the peace of mind or disruption. Although there are numerous credentialing services provider companies around the world, each claiming to be the best, finding the right service would necessitate some investigation. At Optimedservices, we offer credentialing services that are tailored to your specific needs and requirements, allowing you to focus on what you do best: helping people live the healthiest lives possible.

 

Our Services

Get in touch with our credentialing service team

Iqra Haseeb

Introduction:

Organised and efficient Team leading Manager, supporting corporate level officers and senior management personnel with demonstrated expertise in financial and operational leadership. Adroit professional exemplifies multi-disciplinary managerial skills in process procedure and policy improvement initiatives. Accomplished in workflow optimization techniques implementation which increases productivity, reduces labour, and maintains business integrity and quality of service.

Skill: 

Extensive Client Coordination., Conducts business analysis to create value, Provide Support in creating or enhancing the business, Develop and manage strategic partnerships to grow business, Provide Insights or Conduct Studies related to Market or Business Operation related problems, Provide assistance in operating and handling the business, Develop and structure concepts, strategies, automating and scaling the business

Expertise:

Developed and implemented favourable pricing structures balancing firm objectives against customer targets., Education Coordinated innovative strategies to accomplish marketing objectives and boost long-term profitability., Reached out to potential customers via telephone, email and in-person inquiries., Worked with existing customers to increase productivity of  services.

Sharjeel Khan

Introduction:

Having 10 years of experience in the Medical Billing Industry & up to date with Government, Commercial, Automobile & Workers Compensation Payer guidelines throughout the U.S.
Strong knowledge of claims procedures and coding, account receivable/collection, Denial Management, Credentialing/EDI Enrollments and Revenue Cycle Management. Experienced in Electronic Claim (5010) Loop and Segment Editing, Creating Paper to Electronic Claims (EDI 837), Resolving EDI Rejections through Practice Management & Clearing house, creating invoices, customized provider reports, Auditing, processing insurance & patient payments, and pursuing past-due balances through unique & proven RCM process and Data Management.

Skill: 

ICD-10-CM, CPT, Coding Guidelines, Diagnosis Coding, Compliance, Facility/Professional Coding, Complete Revenue Cycle Management, Telehealth or Virtual Visits, Provider Education, CMS-1500, Upper hand in almost every top PM/EMR/EHR Software used, and many more...

Specialties:

Behavioral/Mental Health, Neurology, Family/Internal Medicine, Infectious Diseases, Pulmonary & Sleep Medicine, Pain Management, Physical/Sports Medicine and Rehabilitation (Physiatrist), Chiropractic, Podiatry, Radiology, and much more.

The Full-Service Bundle includes;
  1. Medicare for both one practice county and one provider
  2. Medicaid for both one practice location and one provider
  3. BCBS PID for both the practice and one provider
  4. RailRoad Medicare for both one practice county and one provider