Credentialing & Insurance Panels
Optimize your medical practice by allowing us to ensure that you are in-network with the various managed care organizations.
Knowledgeable Costumer Support
Our experienced, friendly and informative customer support provides you with the answers that you need in order to make your practice successful.
Virtually Expand Your Practice
We become an affordable extension of your staff. We help you with administrative tasks and assist with the managing of documentation requirements.
Multiple Insurance Providers
Contracting with NCQA (National Committee for Quality Assurance) accredited companies.
CAQH monitoring and updating services. Including registration, maintenance and compliance.
Primary source verification such as education, training, licensure, etc.
Individual and facility credentialing and maintenance with all insurance provider types (Aetna, CMS, et al.).
Medicare, Medicaid and TRICARE enrollment and revalidation.
Credentialing Enrollment Services
Our dedicated specialists are here to assist you in completing insurance enrollments, recreditations, revalidations as well as managed care contracting issues.
We offer delegation and de-delegation relations for health professionals joining or leaving new practices.
Our goal is to make sure that you are up-to-date and in-network with the various insurance providers.
Insurance Panel Access
Organized and up-to-date:
We offer provider enrollment, demographic updates as well as primary source verification. We provide credentialing help for all medical specialties and insurance networks. Whether you are an individual provider or a group practice, we can accommodate your credentialing needs. Gain access to insurance panels and optimize your practice’s reimbursements.
Establishing, and maintaining, credentialing is crucial for any healthcare provider or health system. However, navigating through the maze of questions, applications and terminology is a challenge for many healthcare professionals. The staff at ABCS RCM will help you with this process and allow your practice to quickly become a participating provider with the insurance payer of your choice. Even though every insurance provider has their own unique guidelines and procedures, we can guide you through the complicated credentialing process.
Our experience with providing credentialing services on a daily basis, grants us a valuable advantage over many health professionals. This is what we do day in and day out, so processing speeds are maximized and our clients are freed from the tedious chore of earning and maintaining their payer credentialing.
Frequently Asked Credentialing Questions:
For more detailed answers regarding medical credentialing, please CONTACT US!
How long does it take to be assigned an NPI?
A National Provider Identifier (NPI) number is a standardized, unique 10-digit identification that is assigned to health professionals. It usually takes one day to a week to obtain through the National Plan and Provider Enumeration System (NPPES).
Should I use the CAQH?
Yes, the CAQH (Council for Affordable Quality Healthcare) is critical for the credentialing process. Insurance payers will search the CAQH database for medical professionals records. Our full RCM service will monitor the CAQH for you, and warn you if there any irregularities in their system.
What is PECOS ?
P.E.C.O.S. stands for the Provider Enrollment, Chain and Ownership System. The system connects to Medicare and is necessary for healthcare practitioners to monitor if they wish to stay current in the Medicare system. Otherwise, an unforeseen loss of Medicare credentialing can damage a medical practice’s cash flow.
How long does it take to become credentialed ?
There is no consistent answer to this question. It depends on the health professional’s geographical location, medical specialty, insurance type, etc. Ideally, the credentialing process should take between 60 to 90 days. However. every insurance provider is different and longer delays can occur.