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Medical Credentialing Services

ShapeExpert Credentialing for Better Practice Management

Medical Credentialing Services

XpertRCM helps you get approved with commercial and non-commercial insurances, ensuring your practice stays compliant and profitable. As a leading Medical Billing Company, we streamline the credentialing process to save you time and eliminate stress. Our expertise in medical credentialing services guarantees faster approvals, allowing you to focus on providing quality care while we handle the complexities of insurance requirements. Trust XpertRCM to support your practice with seamless, reliable solutions tailored to meet your specific needs.

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XpertRCM Provider Enrollment & Credentialing Services

Enrollment and credentialing services play a crucial role in the healthcare industry. They ensure that healthcare providers meet necessary qualifications and are authorized to provide care. These services include verifying education, training, and professional background. They also involve checking licenses and certifications to confirm they are current and valid. A comprehensive credential assembly service is often integrated into the process to streamline the verification of required documents. The process helps maintain high standards and protects patient safety. It also supports healthcare organizations in complying with regulations and standards set by governing bodies.

Starting your practice and making revenue is the first step to growing. Our credentialing team speeds up your approval process with all payers, from reviewing applications to keeping your data up-to-date with policies and your CAQH profile.

Our medical credentialing process starts with collecting provider enrollment documents and sending them to insurance for you.

Enrolling in health plans can be difficult and time-consuming if you lack experience. The XpertRCM credentialing team knows what to do and will work for you to get you credentialed quickly and easily.

XpertRCM Provider enrollment and credential assembly service ensure you are credentialed and meet state and federal rules to offer healthcare services. We regularly follow up on the application until you are enrolled.

 

Medical Credentialing Specialist

Our provider enrollment and credentialing services make sure your claims go smoothly and you don’t get tangled up with insurance sign-ups. Whether you need Medicare or Medicaid enrollment, we’ve got you covered.

With our Medical credentialing specialist, we guide you through the whole process, from paperwork to joining various insurance plans. We give you all the details you need, help set up insurance accounts, and make sure everything meets NCQA and DHFS standards while also integrating medical billing services to ensure accurate claim processing and faster reimbursements.

With XpertRCM Team of experience in medical credential assembly service, we handle things like EFT/ERA and EDI enrollment. Our credentialing consultants are here to help you get certified in your medical field, which is super important for providing top-notch healthcare.

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Medicare and Medicaid

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Commercial Insurances

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Worker Compensation

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Why XpertRCM Credentialing Services

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Simplified Credentialing Services

XpertRCM specializes in credential assembly service, ensuring smooth enrollment and verification processes. Our team of dedicated representatives supports you through every step, whether it's physician credentialing or qualification verification.

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Efficient Process; Cost Savings

XpertRCM provides a streamlined approach to save you time and money in your medical credentialing endeavors. We handle all paperwork, minimizing administrative tasks. As experts in credentialing and contracting, we keep you informed and offer quick customer service.

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Focus on Patients; Leave Credentialing to Us

With XpertRCM, you can concentrate on patient care while we take care of your contracting requirements. We strive to make the process hassle-free, allowing you to return to your core duties. Reach out to us today for more information or a complimentary quote.

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Value-Added Services By XpertRCM

XpertRCM offers extensive and deep medical billing services in the healthcare industry. We also specialize in medical billing credentialing services, ensuring seamless provider enrollment and compliance. We strive to ensure our clients get the highest possible reimbursement for their services.

Our Medical Credentialing Services

If you’re new to providing services or need to re-credential with insurance firms, we can assist you in simplifying the provider enrollment process through our medical credentialing services.

Recredentialing & Licensing

We periodically review and verify credentialing status to get you re-credentialed on time, so you don’t have to face insurance denials. Through our provider enrollment and credential assembly service, we assist you in obtaining crucial certifications, accreditations, and licenses necessary for successful enrollment with insurance providers.

Electronic Transaction Enrollment

XpertRCM ensures your authorization with all eligible payers, enabling you to conveniently send EDI, ERA, and EFT transactions without any hassle.

IPA Enrollment

Our credentialing consultants make sure to enroll you with insurance providers via Integrated Provider Associations (IPA) on nearby panels.

Contract Negotiation

We handle negotiations with insurance companies on your behalf to increase your contracted amount and improve reimbursement for your practice.

Accreditation Services

Our accreditation services at XpertRCM help your practice gain formal recognition and affiliation, reducing enrollment holds with insurance agencies.

Working Hours

Monday 9am - 5pm

Tuesday9am - 5pm

Wednesday9am - 5pm

Thursday9am - 5pm

Friday9am - 5pm

Saturday - SundayClosed

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Talk to an Expert

    Frequently asked
    Questions

    Medical credentialing is the process of verifying and reviewing a healthcare provider’s qualifications, education, training, licenses, and work history. It ensures that providers meet necessary standards to treat patients and receive payment for their services. Proper credentialing protects patients and maintains high-quality care

    The duration varies, but it typically takes several weeks to a few months. Factors include the complexity of your application, primary source verification, and payer timelines

    No, it’s an ongoing process. Providers must maintain their credentials, update information, and re-credential periodically

    AQH (Council for Affordable Quality Healthcare) is a centralized database that streamlines credentialing. Providers can submit their information once, and insurance companies access it for credentialing purposes.

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    ShapeTESTIMONIALS

    What Our Client Says About XpertRCM?

    We're really happy with the service we get from XpertRCM. Lucas is amazing and always there when we need him, and the whole team knows their stuff and is super polite. I'd definitely recommend this company to others! Thank you very much team XpertRCM!

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    Dr. Sandra J. Ginsberg MD

    I'm thankful for working with XpertRCM. They made it easy for me to switch from my old biller. I have no regrets so far. Lucas and Alex have been very helpful, happy to bring my other company as well. Thank you XpertRCM and Lucas , Alex, and Abul

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    Dr. Kara Kornher

    I've been using XpertRCM since I started my practice in 2018, and I'm really happy with their service. They're a great team—friendly, helpful, and always there when I need them. I've even recommended them to some friends. Shoutout to Danny, Lucas, and William for being especially awesome

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    Trish Leigh

    For the past five years, I've worked closely with various members of the XpertRCM team across different medical practices where I provide diagnostic services. I've been really impressed by their professionalism, dedication, communication skills, and how efficiently they work.

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    Ifrahim Mathew