Provider Credentialing

Provider credentialing is the first step in revenue cycle development. Claims cannot be filed until the insurance carrier approves the provider. Credentialing is a time consuming and tedious task.

Medical Business Management utilizes medical credentialing software and employs dedicated credentialing specialists.  Our credentialing is completed accurately and efficiently.

The Credentialing process is a time consuming and labor intensive.  MBM helps simplify the process by:

  • Complete paper applications (group and individual)
  • Complete electronic applications (CAQH updated every three months)
  • Maintain an electronic provider database
  • Track applications until completion
  • Re-credential as required

MBM’s credentialing goal is to accurately and quickly assemble and submit medical provider applications.  We secure the following for our clients:

  • NPI numbers
  • Provider numbers
  • Electronic Funds Transfer (EFT)
  • Electronic Data Interchange (EDI)
  • Request and complete contracts
  • Name changes
  • Additional locations
  • Re-credentialing
  • Participating membership with HMOs/PPOs

Our process is to collect the required professional and personal information for each provider.  This information is entered into an electronic format with all pertinent supporting documents scanned into the database.  These include:  licenses, DEA certifications, curricula vita, professional training certifications, CEU certificates and other documents that might be required.

Because MBM maintains a catalog of applications, we can populate any application requested.  We review the content and deliver or mail it out for signatures.  MBM provides mailing instructions for returning the signed and completed application.  Then we submit the application and track the progress to verify the status, keeping you informed through the process.

MBM maintains an updated provider data file.  This information is available to our clients and it allows MBM to quickly respond to any credentialing request.