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Credentialing Company
Trusted by Nurse Practitioners
Nurse Practitioner Credentialing Services We Offer
There are over 461,000 nurse practitioners in the USA, and nearly half of them have struggled with credentialing and re-credentialing at some point in their careers. The reason? It is easier said than done to meet payers’ complex and constantly changing nurse practitioner credentialing requirements and get enrolled in their networks.
However, with some professional help, the entire process can be streamlined, and nurse practitioners can get the validation they deserve for investing in their education and becoming the backbone of the U.S. healthcare system.
MediBillMD’s nurse practitioner credentialing services are designed to efficiently manage all steps of insurance credentialing and payer enrollment from start to finish, i.e., document collection to contract signing. Ready to enjoy a career boost?
NP Credentialing
Every certified nurse practitioner, whether providing individual services or group-associated, whether seeing patients on site or via telehealth platforms, is required to get credentialed to meet regulatory compliance and ensure patient safety. We make that happen in the fastest way possible through our nurse practitioner credentialing services.
Re-Credentialing
Insurance payers require nurse practitioners to re-credential every 2-3 years. Why? Because in most U.S. states, nursing licenses are renewed after 2 years, making it compulsory to update records and revalidate new information. Thankfully, our suite of credentialing services for nurse practitioners includes periodic re-credentialing.
CAQH Review & Maintenance
Newness can be overwhelming. The same is the case for nurse practitioners who are new to the centralized database known as CAQH. However, with our insurance credentialing services for nurse practitioners, we simplify CAQH profile creation and ensure it is updated and re-attested every 120 days.
Clearinghouse Enrollments
The world is limiting paper use by going digital, and so should you. Getting enrolled with a clearinghouse is the fastest and safest way to submit electronic claims for your NP services and receive reimbursements online. Unsure how to connect with a clearinghouse? Leave that to us because our nurse practitioner credentialing services include clearinghouse setups.
Common Credentialing Challenges for Nurse Practitioners
Lengthy Processing
Time & Delays
Nurse practitioner credentialing can turn into a time-consuming process, regardless of whether the delay was on your end or the payer’s. Even if you invested hours in preparing and submitting a credentialing application, approval can take weeks because of the payer backlog, preventing you from rendering care to insured patients.
Inconsistent Rules
& Regulations
The nurse practitioner credentialing requirements vary slightly for each insurance payer. For example, some payers may ask for additional references to verify work history, while others may accept the standard number. Also, even if the payer is the same, regulations may differ from state to state, making it challenging to navigate the specifics.
Incomplete or
Incorrect Information
Missing documents, incomplete professional records, unresponsive references, and inaccurate information can hinder credentialing for nurse practitioners. This is because each of these issues will delay the application submission and compel the NP to spend hours preparing the credentialing packet, taking focus away from patient care.
Technical Glitches
& Timeouts
Physicians and nurse practitioners alike have reported system timeouts and technical glitches while preparing and submitting credentialing applications on CAQH ProView. Sometimes, the platform logs users out without saving the entered information, leading to data loss, frustration, and nurse practitioner credentialing delays.
Why Partner with MediBillMD for Nurse Practitioner Credentialing?
MediBillMD is the trusted credentialing partner for nurse practitioners across the United States. In these few years since our inception, we have proven that our masterstroke at combining human expertise with technological capabilities allows us to provide tailored nurse practitioner credentialing solutions that hit the nail every time. We are not just saying it, we have the numbers to prove it.
With our extensive knowledge of the industry, we successfully credentialed 200+ nurse practitioners, and our commitment to creating seamless client experiences (a personal account manager, regular follow-ups and reporting, and 24/7 access to credentialing information) enabled us to transform each interaction into lifelong partnerships. That’s why re-credentialing has become an integral part of our nurse practitioner credentialing services package.
Like other healthcare providers, nurse practitioners also find it challenging to navigate complex credentialing requirements, especially when every payer has its unique dos and don’ts. At MediBillMD, our specialists have decades of experience in credentialing and can expertly adhere to varying payer and regulatory requirements.
By ensuring effective communication and faster problem resolution, we set you up for success. All of MediBillMD’s clients are assigned a dedicated account manager who works proactively to offer tailored credentialing solutions and advice. Rest assured, in their safe hands, nurse practitioner credentialing becomes effortless.
You are already busy monitoring patients’ vitals and tracking their treatment progress. Don’t let credentialing application status checks become another task on your ‘To Do’ list. When you sign up for our nurse practitioner credentialing services, we ensure you are regularly updated through bi-weekly emails, reports, and conference calls.
It may be that you are required to submit documented proof of your pending nurse practitioner credentialing application, or maybe you felt a sudden midnight urge to track the progress. Either way, we give you round-the-clock access to your credentialing information and status. Every update and document is stored in Teamwork for your viewing.
Did they tell you 90-120 days? Move aside, please. Let MediBillMD’s credentialing team handle it. We have mastered the art of swift, error-free, and streamlined insurance credentialing for nurse practitioners. By ensuring foolproof application submission on the first try and maintaining payer communication, we get you credentialed in 45 days.
Whether you are a nurse practitioner in Tacoma, WA, or Tampa, FL, we can help you stand out to payer panels and get recognized for your services. That’s right. MediBillMD’s insurance credentialing services for nurse practitioners are available in all 50 states, covering every city and zip code. With our nationwide network of nurse practitioner credentialing specialists, navigating state-specific requirements becomes a breeze.
Get in Touch with a NP Credentialing Expert
Is ‘incident-to’ billing no longer working out for you? Then it is time to get credentialed and become an in-network nurse practitioner. With our nurse practitioner credentialing services, we will handle the intricacies, so you don’t have to divert attention from patient care.
FAQs
It is advisable to initiate your nurse practitioner credentialing process 90 days before the expected start date. Typically, nurse practitioners who want to start rendering services to insured patients begin the credentialing process 3-6 months in advance, or as soon as they receive their state license.
The nurse practitioner credentialing checklist includes several essential letters, licenses, and certifications that the insurance payer verifies to assess the nurse practitioners’ qualifications and credibility. These include a current RN/advanced practice license, a copy of nurse practitioner certification (ANCC or AANP), a current CPR certification, and an updated CV listing all medical education and positions held in the last 10 years.
Yes. MediBillMD’s complete suite of nurse practitioner credentialing services includes Council for Affordable Quality Healthcare (CAQH) ProView profile setup and review. If you already have a CAQH profile, our credentialing specialists will access and audit it to ensure all the required information is available and up-to-date. However, if you don’t have a CAQH profile, our team will assist you in creating one.
In ideal circumstances, insurance payers take up to 45 days to review and verify a nurse practitioner's credentials. However, sometimes credentialing for nurse practitioners can extend beyond 120 days if the application gets held up due to the payer’s credentialing backlog.
After the nurse practitioner credentialing application is submitted, the payer will review it and check if there is a need for you in the network. If a nurse practitioner is required in the location you intend to practice, they will proceed to verify your details, such as your educational record, work history, licenses, and malpractice insurance records. The thorough vetting process can take 30-120 days.
You don’t have to worry about that if you decide to partner with MediBillMD for nurse practitioner credentialing. It is because our credentialing services for nurse practitioners include bi-weekly follow-ups. Your dedicated account manager will check the status of your credentialing applications and update them in the Teamwork project. He can also email the status updates to you for ease.
There can be several reasons for delays in nurse practitioner credentialing. Sometimes the slowdown can be on your end. For example, imagine that after application submission, the payer reached out to you and requested additional documents, but you took too long to provide the necessary paperwork. In this case, the credentialing will get delayed. Whereas sometimes, it is simply because the payer has too many applications to process.
