PROMBS

Get Paid More Quickly With

Expert Credentialing Services for Professionals
and Organizations Verification, Accreditation,
Customized Solutions

Unlock Growth Potential with Our Top-notch
Physician Credentialing Service

Get Paid More Quickly With

Expert Credentialing Services for Professionals and Organizations Verification, Accreditation, Customized Solutions

Unlock Growth Potential with Our Top-notch
Physician Credentialing Service

Credentialing & Physician Contracting Services

Credentialing and physician contracting services are crucial components of healthcare providers’ operations, ensuring that they are compliant with insurance carrier requirements and that they can offer services to patients who rely on their expertise. However, the credentialing process can be complex and time-consuming, with numerous documents and requirements to comply with. Pro Medical Billing Solutions offers top-tier credentialing and physician contracting services to help healthcare providers navigate these challenges, ensuring that they can focus on providing quality healthcare services to their patients.

At Pro Medical Billing Solutions, we understand the complexities involved in the credentialing and physician contracting process. Our team of experts is well-versed in the requirements of insurance carriers and regulatory bodies, and we have established relationships with all major healthcare carriers. This allows us to navigate the credentialing and physician contracting process efficiently, ensuring that our clients receive the best possible service and results.

Contracting & Pricing

At Pro Medical Billing Solutions, we understand that managing contracting and pricing for your practice can be a time-consuming and complex task. Our team of professionals maintains expertise in the provider credentialing process and stays up-to-date with the latest industry changes, trends, and payer requirements, ensuring a hassle-free experience.

Our team of experts takes on all the responsibilities that typically fall on your staff, freeing up your time to focus on more important tasks. We handle the contracting process from start to finish by collecting all necessary documents, completing the credentialing process, sending applications to payers, and responding to any requests for corrections or additional information from payers.

At Pro Medical Billing Solutions, we understand the importance of staying on top of re-credentialing deadlines. That’s why we assign a dedicated team of experts to track your deadlines and initiate the re-credentialing process each time your practice is due. We work with your organization to fill out the initial application, perform background checks, and verify that all necessary steps have been taken to obtain timely approval for providers.

We understand the importance of keeping your costs low, and that’s why we offer services at prices that are below our closest competitors and other staffing agencies. Our competitive rate covers end-to-end credentialing services, including gathering, auditing, and uploading all necessary documentation, such as resumes, licenses, immunity records, and certifications and diplomas. We offer maximum freedom and flexibility to ensure that our services meet your unique needs.
Our team of experts has extensive experience in obtaining all required documents and missing information for the credentialing process, undertaking site visits, following policies and procedures for credentialing, and maintaining provider manuals and provider tools. We provide a high-quality, agile workforce with robust knowledge of verifying medical records, like drug screens and background checks.
We understand that most insurers depend on CAQH for their credentialing process, and we assist you in creating, updating, and keeping your CAQH up to date. We provide a status tracking dashboard to enhance process transparency and provide the necessary drive to speed up the credentialing application status.
Services We operate from multiple global delivery centers and offer round-the-clock services. We are 100% compliant with the Affordable Care Act, Medicare, HIPAA, and Medicaid. We stay current on municipal, state, and federal guidelines and fine-tune our processes accordingly to keep your records straight and well-organized. We help save time by obviating the need to submit the same information for the same physician multiple times.

If you are looking for expert Credentialing & Contracts services, Get in touch with us today

Physician Credentialing Process with Our Proven Methodology

At Pro Medical Billing Solutions, we understand that physician credentialing is a critical process that can impact the financial health of your practice. That’s why we have developed a proven methodology that streamlines the process and ensures timely approvals. Here’s a look at the physician credentialing process we follow.
Initial Consultation

Initial Consultation

We start with an initial consultation to understand your practice's unique needs and requirements. This helps us develop a customized credentialing plan that fits your practice's specific needs.
Eligibility Verification

Data Collection

Our team of experts works closely with your organization to gather all the necessary information and documents required for the credentialing process. This includes verifying education and training, licensure, work history, and malpractice insurance.
Coding

Application Completion

3
Once we have gathered all the necessary information, we complete and submit the application to the appropriate payer. Our team ensures that the application is complete, accurate, and meets all requirements.
Follow-up & Response Management

Follow-up Insurances

5
Our team tracks the application's progress and follows up with the payer to ensure timely approval. We promptly respond to any requests for additional information or corrections, ensuring the process is expedited.
Claims Transmission

Re-Credentialing

6
We understand the importance of staying on top of re-credentialing deadlines. That's why we assign a dedicated team of experts to track your deadlines and initiate the re-credentialing process each time your practice is due. We work with your organization to fill out the initial application, perform background checks, and verify that all necessary steps have been taken to obtain timely approval for providers.
CAQH Enrollment

CAQH Enrollment

7
We also help providers enroll for CAQH and provide assistance with profile maintenance and updating of records. By streamlining the enrollment process and maintaining accurate records, we ensure that you are always compliant with the latest regulations
Expiring Documents Alerts

Expiring Documents Alerts

7
At Pro Medical Billing Solutions, we understand that credentialing is not a one-time process, but an ongoing one that requires monitoring and tracking. Our credentialing services include monitoring and tracking credential renewal dates and alerting you of the same. Our monitoring services, combined with our centralized file systems, help us have a clear overview of every doctor and every document that is about to expire. It also serves as a checklist for collecting documents. 
Review Contract

Review Contract

7
After getting the approval, we review your participating provider contract. We scan for all important details, such as the claims submission procedures, fee schedule for your services, deadline for filing limits, etc. We believe that it is crucial to review the contract carefully to ensure that all the terms and conditions are clear and acceptable to you. After the review, we hand over all the copies of credentialing applications and contracts to you.
Ongoing Support

Ongoing Support

7
Our team provides ongoing support to ensure that your practice remains compliant with payer requirements. We work with your organization to ensure that all necessary updates and changes are made promptly, reducing the risk of delayed payments.

Conclusion

At Pro Medical Billing Solutions, we understand the importance of an efficient and streamlined physician credentialing process. Our proven methodology simplifies the process, ensuring timely approvals and reducing the risk of delayed payments. Contact us today to learn more about how we can help streamline your credentialing process and improve your practice’s financial health.
We start with an initial consultation to understand your practice’s unique needs and requirements. This helps us develop a customized credentialing plan that fits your practice’s specific needs.
Our team of experts works closely with your organization to gather all the necessary information and documents required for the credentialing process. This includes verifying education and training, licensure, work history, and malpractice insurance.
Once we have gathered all the necessary information, we complete and submit the application to the appropriate payer. Our team ensures that the application is complete, accurate, and meets all requirements.
Our team tracks the application’s progress and follows up with the payer to ensure timely approval. We promptly respond to any requests for additional information or corrections, ensuring the process is expedited.
We understand the importance of staying on top of re-credentialing deadlines. That’s why we assign a dedicated team of experts to track your deadlines and initiate the re-credentialing process each time your practice is due. We work with your organization to fill out the initial application, perform background checks, and verify that all necessary steps have been taken to obtain timely approval for providers.
We also help providers enroll for CAQH and provide assistance with profile maintenance and updating of records. By streamlining the enrollment process and maintaining accurate records, we ensure that you are always compliant with the latest regulations.
At Pro Medical Billing Solutions, we understand that credentialing is not a one-time process, but an ongoing one that requires monitoring and tracking. Our credentialing services include monitoring and tracking credential renewal dates and alerting you of the same. Our monitoring services, combined with our centralized file systems, help us have a clear overview of every doctor and every document that is about to expire. It also serves as a checklist for collecting documents. We send emails notifying practitioners and practices about any imminent document expiry dates.
After getting the approval, we review your participating provider contract. We scan for all important details, such as the claims submission procedures, fee schedule for your services, deadline for filing limits, etc. We believe that it is crucial to review the contract carefully to ensure that all the terms and conditions are clear and acceptable to you. After the review, we hand over all the copies of credentialing applications and contracts to you.
Our team provides ongoing support to ensure that your practice remains compliant with payer requirements. We work with your organization to ensure that all necessary updates and changes are made promptly, reducing the risk of delayed payments.

Conclusion

At Pro Medical Billing Solutions, we understand the importance of an efficient and streamlined physician credentialing process. Our proven methodology simplifies the process, ensuring timely approvals and reducing the risk of delayed payments. Contact us today to learn more about how we can help streamline your credentialing process and improve your practice’s financial health.

Why Proper Credentialing is Essential for the Success of Your Medical Practice

As a healthcare professional, ensuring that your medical practice operates within legal and regulatory guidelines is crucial to success. One of the most critical aspects of running a successful medical practice is proper credentialing. At Pro Medical Billing Solutions Credentialing Services, we understand the importance of this process and offer comprehensive services to help medical practices navigate this complex process.

Proper credentialing is essential for legal and regulatory compliance. Medical practices must ensure that their healthcare professionals meet all necessary standards and requirements. Failure to comply can result in costly fines and lawsuits, damaging the reputation and credibility of the practice. Our credentialing services can help ensure compliance, protecting your practice from potential legal and regulatory issues.

Patient safety is a top priority for any medical practice. Proper credentialing plays a crucial role in ensuring patient protection. By verifying the qualifications of healthcare professionals, medical practices provide assurance to patients that they are receiving care from qualified and competent professionals. This helps build trust between the patient and the practice and can lead to increased patient referrals.

Reputation and credibility are critical factors in the success of any medical practice. A fully credentialed medical practice demonstrates its commitment to hiring qualified professionals. This enhances the practice's reputation and credibility in the healthcare community and can lead to increased patient referrals and revenue. Our physician credentialing services can help your practice improve its reputation and credibility, leading to increased success.

Properly trained and qualified healthcare professionals are better equipped to provide high-quality care. Proper credentialing ensures that healthcare professionals have the necessary skills and qualifications to provide excellent care. This leads to improved patient outcomes and increased patient satisfaction. Our credentialing services can help your practice improve patient outcomes and satisfaction, leading to a more successful practice.

At Pro Medical Billing Solutions Credentialing Services, we offer comprehensive physician credentialing services to help medical practices navigate the complex process of verifying and documenting the qualifications of their healthcare professionals. Our services are designed to help medical practices comply with legal and regulatory requirements, protect patients, enhance reputation and credibility, and improve patient outcomes and satisfaction

FAQ's

The credentialing process in a medical practice involves verifying the education, training, licenses, and certifications of medical professionals who will provide care to patients. This process typically includes gathering and reviewing documentation, conducting background checks, and verifying references.

Improper credentialing in a medical practice can lead to serious consequences, including legal and financial penalties, loss of reputation, and harm to patients. Improperly credentialed medical professionals may not have the necessary qualifications to provide safe and effective care to patients, which can result in medical errors, injuries, and even death.

The responsibility for ensuring proper credentialing in a medical practice falls on the practice management, including the medical director, credentialing coordinator, and other staff involved in the process. The practice must also comply with the credentialing requirements set by regulatory bodies, insurance providers, and accrediting organizations.

Medical professionals should be credentialed at the time of initial appointment to the practice and then regularly re-credentialed based on the guidelines set by regulatory bodies, insurance providers, and accrediting organizations. The frequency of re-credentialing varies depending on the type of credential and the requirements of the organization, but typically occurs every 1-3 years.

Physician Credentialing and Contracting

Conclusion

In conclusion, proper credentialing is an indispensable element that serves as a cornerstone of success for any medical practice, as it ensures compliance with legal and regulatory standards, augments the reputation and credibility of the medical practice, and ultimately results in improved patient outcomes and satisfaction.

Why Choose Pro Medical Billing Solutions for Credentialing Services?

Pro Medical Billing Solutions has extensive expertise in credentialing services. The company’s credentialing specialists are knowledgeable about the credentialing requirements of various healthcare organizations, insurance companies, and regulatory agencies. This enables them to guide healthcare providers through the credentialing process and ensure that they meet all the necessary qualifications and standards.

Pro Medical Billing Solutions works with the healthcare provider to gather all the necessary information and documents required for the credentialing process. This includes completing credentialing applications, obtaining malpractice insurance, and providing proof of education and training.

What Makes Us the Preferred Medical Billing Services Company?

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Here are the top specialties , We are helping healthcare physicians throughout the United States to address their Medical Billing challenges.

Our team comprises of extremely skilled and well-experienced Medical Billing and Coding professionals who are capable of handling any type of Billing requests – Being an ISO certified organization, you can rest assured that all the Medical Billing & Coding Services delivered by our team will be of the best quality and error-free.

If you are searching for a dependable Medical Billing Company - You've found it - Contact us today to learn more about Our services!

Gastroenterology Billing Services

Gastroenterology Credentialing Services

Cardiology Billing Services

Cardiology Credentialing Services

Physical Therapy Billing Services

Physical Therapy Credentialing Services

Neurosurgery Billing Services

Neurosurgery Credentialing Services

Pediatric Medical Billing Services

Pediatric Credentialing Services

Chiropractic Billing Services

Chiropractic Credentialing Services

Pain Management Billing Services

Pain Management Credentialing Services

Behavioral Health Billing Services

Behavioral Health Credentialing Services

Internal Medicine Billing Services

Internal Medicine Credentialing Services

Orthopedic surgery Billing Services

Orthopedic Surgery Credentialing Services

Plastic surgery Billing Services

Plastic Surgery Credentialing Services

Vascular surgery Billing Services

Vascular Surgery Credentialing Services

Radiation oncology Billing Services

Radiation Oncology Credentialing Services

Urology Billing Services

Urology Credentialing Services

Otolaryngology Billing Services

Otolaryngology Credentialing Services

Radiology Billing Services

Radiology Credentialing Services

Dermatology Billing Services

Dermatology Credentialing Services

Anesthesiology Billing Services

Anesthesiology Credentialing Services

Ophthalmology Billing Services

Ophthalmology Credentialing Services

General surgery Billing Services

General Surgery Credentialing Services

Oncology Billing Services

Oncology Credentialing Services

Colon and Rectal Billing

Colon and Rectal Surgery Credentialing

Groups we serving!

- Medical Clinic Setup

- CAQH Registration

- CLIA Setup

- EDI/ERA/EFT Setup

- Software Setup

- PECOS Registration

- Contracts Renegotiation

- Credentialing

- Re-Credentialing

- Hospital Re-Appointments

Here are the top specialties, We are helping healthcare physicians throughout the United States to address their Medical Billing challenges.

Our team comprises of extremely skilled and well-experienced Medical Billing and Coding professionals who are capable of handling any type of Billing requests – Being an ISO certified organization, you can rest assured that all the Medical Billing & Coding Services delivered by our team will be of the best quality and error-free.

If you are searching for a dependable Medical Billing Company - You've found it - Contact us today to learn more about Our services!

Groups we serving!

- Medical Clinic Setup

- CAQH Registration

- CLIA Setup

- EDI/ERA/EFT Setup

- Software Setup

- PECOS Registration

- Contracts Renegotiation

- Credentialing

- Re-Credentialing

- Hospital Re-Appointments

Medical Billing Software We Leverage for Revenue Cycle Management

Here are some Industry top listed EHR being operates by Us.

Our Valued Clients

With Pro Medical Billing Solutions our transition from one E.H.R to another was easy. They are extremely responsive and answer all my inquiries immediately. Reimbursement ratio is at all time high since we became partners. The billing staff is knowledgeable and available whenever needed.

Sam Carr - MD Olympic RCM

Being working with Management of Pro Medical billing solutions for almost last 8 years, I am immensely satisfied with their RCM services and updated knowledge of any changes in guidelines. Their positive and professional work attitude and timely reporting had increased our practice collection...

David Feeback - CFO Colorado Health and Providers

Appreciation for you guys. You all have made a life here smoother than I could have imagined! Your response times are impressive! Your staff is Awesome! You all have been the best, outsourced billing company I’ve worked with.

Nell Sampson - Practice Admin G&A Wellness Clinic

Our collections have remained incredible from the last 15 months , our first pass rates increased and our PC% are above industry standards. You Guys are highly responsive, I would recommend Pro Medical Billing Solutions for any practice wanting to take control of their revenue cycle. We simply don’t worry about collections.

Dr. Mukherjee Ranadev - MD CO-FOUNDER Digestive Associates

We are happy that we found Pro Medical Billing Solutions which is the right billing service Solution. Our revenues since switching have improved and we appreciate them. Professional and loyal team, always available for help.

Maria Balderaz - Practice Administrator Alliance Risk Group

Extremely you guys are doing an amazing effort getting our revenue up and cash flow is getting better than before! Thank you for your wonderful effort. Thumbs-up to you and your team.

Dr. Jorge Guevara - MD Outcomes Detox & Recovery Center