Credentialing

Incorrect credentialing can cost you- with a lower rate

Credentialing is an intricate process that never stops for providers. Contracts are constantly expiring and there are a host of missteps that can reduce payments to you, or even redirect payment to the patient! Credentialing is so essential to revenue flow, yet some medical billing companies don’t do it, forcing the provider to find another outsourcing vendor. Dividing your billing between two vendors is a recipe for errors. This is never the case with DocFinancial. We are committed to keeping your credentialing up to date and linked appropriately between provider and payer.

DocFinancial credentialing is process-driven, correct and timely

Credentialing is something that many physicians don’t realize is absolutely crucial, not only to ensure that the right rate is paid, but also to make sure payment is received at all.

At DocFinancial we understand that unless there is a connected chain of data linking the provider to the group, to the NPI (National Provider ID) to the insurance company group so that you can be paid at the contracted rate, you can be shortchanged by a broken chain. We are proud of the years of experience, and accuracy, that we bring to this highly detailed work.

Insurance Contract negotiation – the professional help you need to do it right

As you know, every 3-5 years insurance contracts need renewal. A technology based reminder can be sent, but if there’s not someone on top of the negotiating process, you can be faced with a long term barrier to payment. Staff turnover at insurance companies can further clog the pipeline. The result is that it may take as long as 6 months to complete!

We make complex negotiations simple – and you have the final say

At DocFinancial, our billing manager conducts contract negotiations on your behalf, with your feedback.  We know every company’s strengths, weaknesses, and rates. We can make sure that you get a fair rate and that your chain of payment is secure, transparent and correct. No busy medical group has time for this, DocFinancial does.

Step by step insurance contract negotiations with DocFinancial:

  • Six months before renewal date – negotiations begin
  • We discuss your preferred conversion factor per procedure
  • It’s our mission to obtain the highest accepted rates possible for you
  • We are the go-between your practice or group and the insurance company
  • Negotiate the contract
  • Receive your feedback
  • You sign final contract, we send signed contract to the insurance company
  • We confirm that contract is loaded in the insurance company at the time of renewal

Onboarding new hires in the group – simplifying the process

When a new physician joins your group, our trained professionals make sure the provider’s service address is linked to all facilities and service locations. We help you simplify the process to gain all the documentation needed:

  • Active state medical licenses
  • DEA registration
  • Medical school diplomas
  • ECFMG certificate
  • Residency, internship, and fellowship certificates
  • National Provider Identifier (NPI) documentation
  • Board certification(s)
  • Malpractice liability insurance certification