Adean.co is a leading Medical Credentialing Service Provider. Our Outsourced Credentialing Services relieve administrative burdens, secure privileges, ensure in-network integration, and speed up reimbursements. As a Provider Credentialing Company, we’ve empowered doctors, nurses, and therapists to excel in their careers. Join the ranks of satisfied practitioners with our Doctor Credentialing and Enrollment Services.
Maximize financial rewards with first-preference reimbursement rates, earning more for the same services.
“Swift Reimbursement” is a term commonly used in healthcare, insurance, and financial services.
"Maximum Privileges" denotes the highest access level and control a user/account has within a system.
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"Minimize Denials" is a crucial goal for healthcare providers, medical billing companies, and RCM firms.
Credentialing is the process of verifying the qualifications, skills, and experience of healthcare providers to ensure they meet the standards of a healthcare organization, insurance company, or government agency. It’s a complex and time-consuming process that can be overwhelming for healthcare providers
We assist healthcare providers in enrolling with Medicare and Medicaid, ensuring they can offer their services to eligible beneficiaries under these government programs.
Our team helps healthcare providers navigate the complex process of credentialing with commercial insurance companies, ensuring they can participate in these networks and receive reimbursement for their services.
We handle the registration process for National Provider Identifier (NPI) numbers, both Type I for individual providers and Type II for organizations, streamlining the essential identification required for billing and claims
We facilitate the registration and ongoing maintenance of your Council for Affordable Quality Healthcare (CAQH) profile, simplifying the provider data collection process for participating health plans.
Our team provides expert support in contract negotiation with insurance payers, helping providers secure favorable terms and conditions for their services, maximizing reimbursement rates and minimizing administrative burdens
We facilitate the revalidation and re-credentialing process for healthcare providers, ensuring their continued compliance with regulatory requirements and maintaining their active status with payers.
Our credentialing and privileging specialists audit reimbursement issues, such as underpayments, denials, delays, or errors from insurance payers. Providers also get accounts receivable (AR) follow up services to help collect outstanding payments from payers. By auditing reimbursement issues and following up on AR, providers can improve their cash flow, reduce their bad debt, and optimize their revenue cycle.
Experience the advantage of a dedicated project manager who guides you through the process. Our award-winning customer service ensures you’re in good hands.
This is very sensitive process to submit credentialing application to insurance companies.You should choose professional medical credentialing expert who can submit your application to join the network. Adean Credentialing team has more than 10 years of experience so they know the information is required for any type of Specialty. We are submitting application in right way there will be no chance for rejection. As compare to other outsource companies our services are affordable and best for any type of Provider.
Adean is the best provider Medical credentialing company for practices across all 50 states of the USA
Are you Looking for the best credentialing solutions by credentialing specialist companies near you? With over a decade of experience, Adean is the best provider medical credentialing company for practices across all 50 states of the USA.
We start by thoroughly assessing your specific practice needs and the requirements of your state and the payers you want to work with. From there, we leverage our extensive payer contracts and relationships to compile and verify all necessary documents, licenses, certifications, insurance, and more to meet each payer’s distinct criteria.For example, when credentialing a physician in California, we would verify their medical license with the Medical Board of California, check for any disciplinary actions on the National Practitioner Data Bank, review their malpractice insurance coverage, and collect a current CV and diploma before submitting to health plans like Blue Shield of California and Health Net.
Additional credentialing services like re-credentialing, expediting credentialing, and credentialing for locum tenens providers are also a part of Adean Provider Credentialing and Enrollment Service offerings.
Enroll with ease through our streamlined process. We offer comprehensive assistance for selecting and enrolling with your preferred payer. Whether you're navigating Medicare, Medicaid, or private insurance, our experts ensure a smooth enrollment experience tailored to your needs
Credentialing plays a crucial role in risk mitigation. When organizations assess healthcare professionals' qualifications and competence before granting privileges, they reduce the likelihood of patient harm. This proactive approach also reduces a healthcare provider's legal risks
It not only provides you with the assurance that you are meeting all of the requirements to provide quality care and remain compliant, but it also helps with the following: Increased Visibility: Credentialing your practice allows you to become more visible to potential patients and payers
Turnaround time varies among insurance carriers, with major carriers generally taking 90-120 days and smaller carriers potentially taking longer. Upon submitting a participation request to a commercial carrier, providers undergo two processes: credentialing and contracting. Credentialing involves verifying all credentials and committee approval. Once approved, providers proceed to contracting and receive their effective date. Commercial carriers do not allow retroactive billing, meaning providers are compensated only for claims submitted after being listed as “In-Network” in the carrier's system. Out-of-network billing results in higher costs for patients, who may be responsible for the entire bill.
For insurance credentialing, providers typically need:
A CP575 is a form issued by the Internal Revenue Service (IRS) in the United States. It is also known as the "Confirmation of Employer Identification Number (EIN)" letter. This form is used to verify the Employer Identification Number (EIN) assigned to a business entity by the IRS. It serves as official documentation confirming the EIN for various purposes, including enrolling in Medicare or completing business transactions that require verification of the entity's tax identification number.
To complete Medicare revalidation, follow these steps:
Receive Notification: Medicare will send you a revalidation notification letter about 6 months before your revalidation date. This letter will include instructions on how to complete the process.
Access Provider Enrollment, Chain, and Ownership System (PECOS): Log in to the PECOS system using your credentials. PECOS is the online Medicare enrollment system where you will complete the revalidation.
Review and Update Information: Verify that all your information in PECOS is accurate and up to date. This includes your practice location(s), contact information, and any other required details.
Submit Application: Complete the revalidation application in PECOS. Ensure all required fields are filled out correctly. You may need to upload supporting documents such as your IRS form CP575, licenses, certifications, and other relevant paperwork.
Monitor Application Status: After submitting your revalidation application, monitor the status in PECOS. Medicare may request additional information or documents if needed.
Receive Approval: Once your revalidation application is processed and approved, Medicare will send you a confirmation notice. Your provider enrollment record will be updated with a new revalidation date.
Keep Records: Keep copies of all submitted documents and correspondence for your records.
Yes, having a service location is typically necessary to begin credentialing with insurance carriers. The service location is where you will provide medical services to patients, and it needs to be properly documented and verified during the credentialing process. Insurance carriers require this information to ensure that you have a physical practice location where patients can receive care.
When starting the credentialing process, you'll usually need to provide details about your service location(s), including the address, contact information, and sometimes proof of lease or ownership of the premises. This ensures that the insurance carrier can accurately list your practice as an in-network provider and process claims accordingly.
If you are in the process of setting up a new practice or clinic, it's advisable to have your service location established or at least in the final stages of preparation before beginning the credentialing process. This helps streamline the process and ensures that your credentialing application can progress smoothly.
For provider enrollment with Medicare, the application used is the CMS-855 form. This form is used for various types of providers and suppliers to apply for enrollment or to revalidate their enrollment in the Medicare program. The specific CMS-855 form you use depends on the type of provider or supplier you are, such as:
Each form collects specific information relevant to the type of provider or supplier applying for Medicare enrollment. These forms are submitted electronically through the Provider Enrollment, Chain, and Ownership System (PECOS) or by mail to your Medicare Administrative Contractor (MAC) depending on the preference and requirements.
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