- Physician Credentialing
Physician Credentialing Services
Get your credentialing application accepted the first time
What is Physician Credentialing?
Physician credentialing and provider enrollment services is a process of enrolment and attestation that a physician is part of a Payer’s network and authorized to provide services to patients who are members in the Payer’s plans. Credentialing verifies that a physician meets standards as determined by the Payer by reviewing such items as the individual’s license, experience, certification, education, training, affiliations, malpractice & adverse clinical occurrences and clinical judgment.
Why opt for physician/provider credentialing services?
Effective provider credentialing services are the absolute necessity for better performance of the practice. Without proper enrolment, payments can be delayed or refused by the insurance carriers, even if the physician is able to provide services that are competent and medically necessary.
We at e-care India offer Physician credentialing services, helping Providers achieve better revenues. Our tailor-made provider credentialing services facilitate the payer enrollment process when a Physicians
- Begin the first practice after Med school
- Change from one Practice to another
- Adding New Physician to an existing Group
- Want to become enrolled with a new Payer
Different Payers have their own set of forms to be filled either online or through paper applications. Once submitted, there should also be diligent follow-up with the Payers to ensure that the provider credentialing process is completed in the shortest time so that the revenues are not impacted.
Our Physician Credentialing Services
Initial Physician Credentialing
We manage the complete credentialing process for newly practicing physicians and those joining new healthcare organizations.
Provider Enrollment
Our team assists physicians with enrollment in Medicare, Medicaid, and commercial insurance plans, ensuring timely network participation.
CAQH Profile Management
We create, maintain, update, and attest CAQH profiles to simplify credentialing with multiple insurance carriers.
Re-Credentialing Services
We monitor renewal deadlines and complete re-credentialing applications to help physicians maintain uninterrupted participation with insurance networks.
License & Certification Monitoring
Our specialists track medical licenses, DEA registrations, board certifications, and other credentials to ensure continuous compliance.
Hospital Privileging Assistance
We support physicians with hospital credentialing and privileging applications, helping them obtain clinical privileges efficiently.
Common Physician Credentialing Challenges
Healthcare providers often encounter challenges such as:
- Lengthy payer approval timelines
- Incomplete or inaccurate applications
- Missing documentation
- Frequent follow-ups with insurance companies
- Expired licenses or certifications
- Delayed provider enrollment
- Administrative burden on practice staff
- Lost revenue due to credentialing delays
Benefits of Outsourcing Physician Credentialing
- Faster Provider Enrollment: Accelerate physician enrollment with insurance payers and reduce approval delays.
- Reduced Administrative Burden: Free your internal staff from managing complex credentialing paperwork and follow-ups.
- Improved Compliance: Ensure physician credentials remain current and compliant with payer requirements.
- Minimized Enrollment Errors: Accurate application preparation reduces rejections and resubmissions.
- Faster Reimbursements: Credentialed physicians can submit claims sooner, improving cash flow and revenue.
Our Physician Credentialing Process
The following process is followed as part of e-care’s physician credentialing services:
1
Handling Provider letter of interest and application requisition from Payers.
2
New provider affiliations and Group Credentialing.
3
Facility Credentialing including addition of Providers to the Facility’s ID.
4
Preparation of paper CMS 855 and other Managed Care applications for all Payers including DME and Dental payers.
5
Preparation and submission of online applications to federal, state and commercial carriers.
6
Maintain and update specific Provider information directly with carriers at frequent intervals or when requested.
7
Resolve enrolment issues and track Managed Care contracts.
8
Preparation of contracting documents for scanning and Long-term storage electronically.
9
Prepare, maintain and monitor Managed Care Summaries that Provides Effective dates, Fee Schedule details and Group affiliation.
10
Monitoring Expiry dates for NYS-Registrations, DEAs, and CLIA registrations and also handling re-applications.
11
Handling Re-Credentialing whenever required.
Why Choose e-care India?
- Over 20 years of healthcare outsourcing expertise
- Dedicated physician credentialing specialists
- End-to-end credentialing and payer enrollment support
- Experience with Medicare, Medicaid, and commercial insurers
- Proactive follow-up to reduce enrollment delays
- HIPAA-compliant processes
- Cost-effective offshore credentialing solutions
- Trusted by healthcare providers across the United States
- In general & on average, expect to pay $2,000 - $5,000/year for physician credentialing services.
- Average cost is $150-300/physician, though this varies across credentialing service providers.
- Initial setup can cost between $200-800
- Per panel, expect to pay around $100 for an application
How much physician credentialing and provider enrollment services cost?
Frequently Asked Questions
01.Why is physician credentialing important?
Physician credentialing enables healthcare providers to participate in insurance networks, submit claims, receive reimbursements, and maintain compliance with payer and regulatory requirements. Proper credentialing also helps build patient trust and supports uninterrupted revenue generation.
02. How long does physician credentialing take?
The process typically takes 30 to 180 days, depending on the payer, provider type, and completeness of the submitted documentation.
03. What documents are required for physician credentialing?
Common requirements include a medical license, DEA registration, NPI, board certifications, malpractice insurance, CV, education records, and work history.
04. Do you provide Medicare and commercial payer enrollment?
Yes. We assist physicians with Medicare, Medicaid, and commercial insurance payer enrollment, ensuring accurate application submission and timely follow-up.
05. Why choose e-care India for physician credentialing?
Our experienced credentialing specialists provide end-to-end support, reduce enrollment delays, ensure compliance, and help physicians become reimbursement-ready faster.
Get Started with e-care India
Simplify the physician credentialing process with e-care India’s expert support. We help healthcare providers reduce administrative burdens, accelerate payer enrollment, and maintain continuous network participation for improved revenue cycle performance.
Contact us today to learn how our Physician Credentialing Services can support your practice’s growth and financial success.