Why Outsource Medical Credentialing Services?
In-house credentialing is time consuming and very error-prone. Minor documentation errors may result in loss of revenue, delayed enrollment or loss of payers. Credentialing is one area where outsourcing is useful to keep the practices stay compliant and financially stable.
Benefits of Outsourced Credentialing Services
Lean provider onboarding & approvals by payers.- Minimized internal team workload.
- Enhanced precision with standard processes.
- Continued adherence to payer and regulatory compliance.
- Reduced possibility of enrollment lapses and claims denials.
The provider credentialing services offered by Velan, will be created to take charge of the entire credentialing process in an accountable and precise way to ensure that the providers stay active within the payer networks.
How Outsourced Credentialing Supports Your Practice
We have a systematic process that subdivides the credentialing process into manageable steps that enhance transparency and turnaround times.
Provider Documentation Collection
Licenses, certifications, and education history- Malpractice insurance and work history
- Identity and compliance documentation
Primary Source Verification
- Direct validation via approved primary documents
- Verification of licenses, board certifications, and training
- Payer and accreditation standards alignment
Payer Enrollment Submission
- Medicare, Medicaid, and commercial payer applications
- Complete, clean submissions to reduce rejections
- Support of healthcare provider enrollment requirements.
Application Tracking & Follow-Ups
- Persistent follow-up with payers
- Timely responses to requests for additional information
- Intensive follow-ups to avoid delays in processing.
Approval & Provider Setup
- Provider activation in payer systems
- Claim submission preparedness of billing platform
Re-Credentialing & Ongoing Monitoring
- Keeping of expiration and renewal dates of credentials
- Ensuring uninterrupted payer participation
Tired of the credentialing hassle? Let our team handle it so you can focus on patient care.
What Services Are Included in Our Medical Credentialing Services?
Velan provides healthcare credentialing services that are specific to hospitals, clinics, and group practices, as well as multi-specialty organizations.
Credentialing & Verification
- Checking of license and credentials as primary sources
- Checks on compliance were in line with the payer verifications
Payer Enrollment Services
- Complete coverage on Medicare, Medicaid, and non-government plans
- Preparation of applications, their submission and coordination with payers
CAQH Profile Management
- Profile generation, modification and certification
- Under constant supervision to prevent deactivation of the payers
NPI & PECOS Administration
- NPI registration and updates
- PECOS Medicare billing and maintenance
Re-Credentialing & Renewals
- Automated monitoring of expired credentials
- On-time renewal to ensure compliance
Credentialing Compliance Audits
- Internal audit to determine whether documentation is accurate
- Payee and regulatory compliance
How Do Medical Credentialing Services Work?
Credentialing comes as a process that entails the existence of a structured work process where the payer and regulatory requirements are met without any interruption of the providers.
Step-by-Step Credentialing Process
Data Collection & Review
The information of the providers in terms of licencing, certifications, and practice information is gathered and scrutinized carefully. This is necessary to make sure that all records have been done, correctly and can be verified.
Verification Stage
All credentials are verified with the primary sources that are authorized. This verifies provider credentials, license, as well as regulatory standards.
Payer Enrollment Submission
Applications are submitted to payers once they are completed along with the supporting documentation themed. Proper submissions reduce rework and accelerate approval processes.
Follow-Up & Status Tracking
The payers have regular follow-ups done to ensure that the applications are on track. The use of active communication will help to correct any issue emerging and prevent unnecessary delays.
Approval & Contracting
The payer registers and contracts providers on approval. This will enable them to initiate billing and reimbursements to be received.
Ongoing Monitoring
Provider credentials, renewals and compliance are constantly monitored. This guarantees continuous collaborations with payers and decreases the chances of lapses.
Velan – A Trusted Medical CredentialingServices Company
Velan is an organization that has been automating processes related to credentialing of healthcare organizations in more than 19 years. With expert accuracy, our credentialing specialists handle the provider verification and the re-credentialing and payer coordination.
We are also in physician credentialing services and hospital credentialing programs which assist organizations to grow without adding to administrative overhead. We are able to reduce approval cycles and rework by using standardized workflow and processes that are based on compliance. Credentialing Performance Metrics.
-
1000+
Healthcare Facilities Supported
-
50,000+
Credentialing Applications Processed
-
99.5%
Documentation Accuracy Rate
-
98%
First-Pass Approval Rate
Case Studies
Blog
Frequently Asked Questions
They check the healthcare providers and add them to insurance payers to ensure that no delays and denials in claims occur.
Outsourcing is a way of minimizing the administrative burden, enhancing accuracy and accelerating the payer approvals.
Checks, enrollment of the payers, CAQH, management of NPI as well as PECOS and re-credentialing.
OPPE and FPPE are assessment programs applied in healthcare organizations to determine provider performance and competency.
Clean and accurate submissions are guaranteed by standardized workflows, review by experts and various quality checks.
Streamline Provider Credentialing Process Services and get a peace of mind. Let’s Meet & Discuss Your Need!
Our Certification
