Credentialing

Would you prefer that you and your staff focus on paperwork or patients?

Each Insurance Carrier you apply for typically requires dozens of pages of paperwork, and lengthy online applications.

We act as an extension of your practice to complete all the paperwork and diligently follow up to get you credentialed with as many payers as possible.

Expand your patient base with AMD Insurance provider enrollment nationwide including:

• Commercial Payer Enrollment (Aetna, Blue Cross/Blue Shield, Cigna, Keystone, Humana, UnitedHealth Group, Anthem, WellPoint, Kaiser, Highmark, etc)
• Government Payer Enrollment (Medicare/Medicaid)
• Re-credentialing

We all know that patients’ rarely if ever will pay out of network, so it is critical to accept as many insurance plans as possible. Of course you would prefer to have yourself and your office staff focus on the patients medical needs. That is where our experience in medical credentialing can help you not only maintain your current patients’ insurance participation but expand your practice as well.

We offer credentialing for :

Our expertise in the area of credentialing will increase your chances of approval and save you the time and headaches involved with the application and follow-up process.

We can help enroll you in the insurance carriers best suited for your practice’s needs.

We can help you throughout the process from credentialing prep to re-credentialing when necessary. (Also see our Medical Billing section for continued services to get your practice paid after you have been officially enrolled.)

How important is it for your practice to be ‘in network’?

As your front office can probably attest most potential new patients will first ask if you are participating with their insurance. If you are not in their network then odds are they will not make an appointment with your office.

Also, since the health plans cover more pre-existing conditions, expanded mental health services, etc being an approved provider is more beneficial to the bottom line of your practice.

AMD Credentialing Services Include:

Full Service Credentialing

Completion of credentialing applications for insurance carriers and hospitals.

We will also do all necessary follow up with insurance carriers and track the application through to the approval stage.

Maintain Credentialing Documentation

We maintain all pertinent credentialing documentation (e.g. DEA, CDS, Medical Licenses, Board Certificates, Malpractice Insurance Face Sheets, CME’s etc.

Distribution of Renewed Documentation

We distribute all renewed documents including DEA, CDS, Malpractice Insurance Face Sheets, Medical Licenses, updated CME’s etc., to insurance carriers and the hospitals.

Document Tracking

We track and provide advanced notification of expiring licenses, DEA, CDS, etc. 

We function as the liaison between the practice and the insurance carriers and hospitals with all matters relating to the credentialing/re-credentialing process.

Insurance Matrix

We will provide your office with an insurance matrix, which lists the individual physician, each insurance carrier and the physician’s status with the plan, Personal Identification Number and effective date with the insurance plan. The matrix will be updated each time there is a change in status

Completion of CAQH Proview Profile

• Register providers and groups with the NPPES to obtain an NPI number
• Enroll for Electronic Funds Transfer (EFT)
• Enroll for Electronic Remittance Advice (ERA)

Contact AMD Medical Billing and Credentialing Services today by phone at 1-877-782-1373 or by email at Info@AMDMedicalBilling.com

We act as an extension of your practice!