Credentialing Services For the Insurance Industry
If you need credentialing services, but aren’t sure who to turn to, you can read about Business Integrity Services, Teleios Collaborative Network, and Bikham Healthcare. We’ve also highlighted the many different credentialing services for the insurance industry, and provided a list of key features to look for in a credentialing service. Whether your credentialing needs are general or complex, you’ll want to consider the following:
Business Integrity Services
In 2019 Business Integrity credentialing services was founded to meet the growing demand for back office support in healthcare organizations. It has expanded its services to serve other service-oriented companies, including insurance companies and financial institutions. The company has more than 200 years of combined experience in revenue cycle management, and has a staff of subject matter experts in a variety of areas. Business Integrity Services offers healthcare organizations back-office support, and keeps up with technology trends.
The company offers services that address risk management, operational performance, and business integrity. Through these services, organizations can improve their business performance and manage risks better. Governance and continuous improvement efforts are essential to ensuring high-quality data. For example, securing data is the first step in ensuring data quality and security. Having better quality data will drive synergy across an organization. It also provides compliance services. Businesses are increasingly turning to shared services centers to reduce costs and enhance capabilities.
Teleios Collaborative Network
The Teleios Collaborative Network is an organization that supports hospice care and other nonprofit organizations by providing credentialing services. The primary purpose of credentialing is patient safety, and the Teleios Collaborative Network collects and reviews practitioners’ documentation to ensure that they are certified and up to date on all aspects of practice. Credentials are verified through primary source verification, which refers to credentials as verified directly from the source or designated equivalent. Those credentials are also subject to a review of the practitioner’s malpractice history, professional peer references, and six key elements of quality.
The Teleios Collaborative Network is a clinically integrated network that shares leadership and resources with its member organizations. These organizations are part of a broader community health care network that provides clinical services to patients, families, and caregivers. The Teleios Collaborative Network was founded by Four Seasons, Carolina Caring, and Mountain Valley Hospice, and currently has eleven member organizations in North Carolina, South and Virginia.
Bikham Healthcare
A comprehensive set of credentialing services provided by Bikham Healthcare can streamline the credentialing process. These services include network research, application filing, follow-up, closed-panel appeals, out-of-network enrollments, and annual credentialing maintenance. In addition, Bikham’s team follows up with clients to ensure that all pertinent information has been received and that the process is proceeding smoothly.
If you need assistance in submitting your application to health plans, you can hire a billing service. Bikham Healthcare’s account managers are experienced in working with physicians to secure the best possible fee rates and maximize enrollment opportunities. Credentialing accounts are managed by a single team, and a Bikham Healthcare credentialing account manager works closely with a billing manager to identify the most efficient ways to maximize the benefit of each client.
1st Credentialing
A physician cannot operate without credentialing services. Enrollment with insurance companies is essential for reimbursement, and without credentialing services, they could not accept payments from insurance companies. The process of enlistment requires careful attention to detail, and consistent follow-up. Any delay in the process could severely impact revenue and practice success. To help physicians navigate this process more efficiently, here are some tips:
Enrolling with insurance companies can be complicated and time-consuming. To avoid the hassles, 1st Credentialing handles the process for their clients. They will notify their clients of their application status and any carrier response. This service gives them the peace of mind to perform their medical practice. It is also convenient to work with a credentialing service that focuses on the process of enlisting healthcare providers.
OCHIN
OCHIN Credentialing Services are dedicated to ensuring that providers have the credentials they need to provide excellent patient care. The services include a comprehensive review of credentialing applications and verification of licenses, credentials, and insurance. The credentialing coordinator processes applications for payers and providers and resolves any discrepancies and unresolved issues. Credentialing services are also responsible for ensuring that the integrity of the provider information is maintained.
OCHIN’s credentialing services are designed to support equitable access to high-quality care while reducing the administrative burden on community-based health care providers. Credentialing is a time-consuming process, and without it, organizations risk losing out on critical revenue. Moreover, many OCHIN members participate in dozens of health insurance plans. As a result, enrollment applications must be submitted to dozens of health insurance plans. The process can be lengthy and inefficient.
