Credentialing and Contracting
We provide a comprehensive, end-to-end solution for provider credentialing and payer contracting to ensure your practice gets paid faster and more effectively for the services you provide.
What is Credentialing and Contracting?
Provider credentialing is the critical process of verifying a healthcare provider’s qualifications to ensure they meet the required standards for practicing medicine and participating with insurance networks. Contracting is the subsequent step of negotiating the terms of reimbursement with those payers. Without proper, timely credentialing and strategic contracting, your claims will be denied, leading to significant revenue loss and a barrier to patient access. EZMed Professionals manages this entire intricate process, transforming a complex administrative burden into a streamlined pathway to profitability.
Our Comprehensive Credentialing Philosophy
At EZMed Professionals, our approach to credentialing is built on a foundation of precision, communication, and strategic partnership. We understand that this process is not just paperwork; it’s the bedrock of your practice’s financial health.
Accuracy and Diligence
We eliminate errors and omissions from the start, ensuring every application is submitted correctly the first time to prevent costly delays.
Proactive Communication
You are never left in the dark. We provide clear, consistent updates and manage all payer communication on your behalf.
Strategic Negotiation
We go beyond standard enrollment by analyzing and negotiating payer contracts to secure the best possible reimbursement rates for your services.
Our Meticulous End-to-End Credentialing Process
Our proven methodology ensures no detail is overlooked and your applications move through the system as efficiently as possible. We handle every step with meticulous care.
Initial Consultation & Document Collection
We begin with a thorough consultation to understand your practice’s specific needs. Our specialists then provide a clear checklist and assist you in gathering all necessary documentation, from licenses and certifications to work history and insurance details.
Application Preparation & CAQH Management
We meticulously prepare and complete all necessary applications for your targeted government and commercial payers. This includes creating, attesting, and meticulously maintaining your CAQH (Council for Affordable Quality Healthcare) profile.
Multi-Point Application Review & Submission
Before submission, every application undergoes a rigorous internal audit to ensure 100% accuracy and completeness. This quality assurance step is key to preventing the rejections and delays that plague the credentialing process.
Persistent and Professional Payer Follow-Up
We don’t just submit and wait. Our team engages in persistent, professional follow-up with every payer, ensuring your application is actively progressing. We swiftly resolve any issues or requests for additional information that may arise.
Contract Review, Negotiation & Finalization
Once an application is approved, we review the proposed contract in detail. We leverage our industry expertise to negotiate favorable terms and reimbursement rates on your behalf before you sign, ensuring a financially beneficial partnership with the payer.
Ongoing Maintenance & Re-credentialing
Our service doesn’t end after enrollment. We proactively track all your expiring credentials and manage the entire re-credentialing process long before deadlines, guaranteeing you never experience a lapse in your network status.
The Common Credentialing Challenges We Solve
If your practice is struggling with the complexities of billing, you are not alone. We provide targeted solutions to the most pressing challenges in healthcare today:
Preventing Costly Revenue Delays and Denials
Navigating Complex and Evolving Payer Requirements
Eliminating Your Administrative Burden
FAQs About The Service
There are many questions about the service, we have selected frequently asked questions about this service. If you do not see your answer, please contact us.
