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PROVIDER CREDENTIALING

As a healthcare provider, you must be aware of the importance of Provider Credentialing. It is a verification of your experience and expertise as a healthcare provider and your interest and willingness to provide services. Above all, without credentials, you will be able to practice medicine in a cash-only mode without the privileges at hospitals or other facilities. Provider Credentialing at QWay is faster and more transparent for the healthcare provider as we have a home-grown solution to serve the purpose.

Provider Credentialing is critical for the practice of a physician. It isn’t just another form to be filled. It is a complex process with many steps and most of all it is ongoing. QWay Healthcare approaches Provider Credentialing as a process that requires complete and constant maintenance and management. We offer Provider Credentialing as a solution and as a service and cater to the end-to-end management of the credentialing process.

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    See below the key aspects of our Provider Credentialing Service.

    • We understand that Credentialing does not stop after the physician or the healthcare provider has submitted the forms. This is why we take the necessary steps to prompt physicians to give us data periodically about their practice and service.
    • While most practices manage credentialing manually or use an electronic database that has limitations in connecting with other databases, we use a high-end Credentialing Software in order to reduce the paperwork and offer physicians, healthcare providers and payers instant and the latest status about each other.
    • Credentialing is not complete even after the submission of myriad documents to a number of third parties for verification. Although most health plans and facilities do not mandate a full re-hash of the documents, it is necessary to submit annual updates. QWay manages the ongoing maintenance of credentialing information by adding staffing resources and creating a sustainable workflow.

    Prioritize Credentialing to stay in practice. Choose QWay Healthcare to stay fully enrolled with participating health plans, and give patients admitting privileges.

    FREQUENTLY ASKED QUESTIONS

    • 1. What are the basic details needed for provider credentialing?

      The details needed for the provider credentialing procedure are: educational qualifications, specialization certificates, board certifications, NPI number, Tax ID numbers and peer reviews among several others. These details go through the primary source verification process to proceed with the application of the provider.

    • 2. Why is provider credentialing important for a healthcare professional?

      The provider credentialing is an extremely important process to determine the competence of the healthcare professional. On one hand, the insurance companies only proceed with the reimbursements after the due credentialing process is completed. On the other hand, it presents a transparent picture to the patients who can look for the right credentials of their providers before approaching them.

    • 3. How can you simplify provider credentialing procedure?

      The provider credentialing is a particularly complicated process. It can be simplified with the help of expert professionals who are competent in handling of several documents and processing them according to the specific needs of the separate insurance companies. The team at QWay will make sure that the process is simplified so that you can concentrate on your patients as well as stay “in-network”.

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