BC Advantage - 2022 Issue 2

What's the difference between Credentialing and Contracting a Provider?

What Is Credentialing?Credentialing is the formal process of verifying a provider's qualifications. This ensures that doctors and nurses have the proper training and experience to provide the highest level of care to patients. The provider credentialing process is completed by verifying all provider documents and ensuring that they are valid and current. Most health insurance companies will not even offer reimbursements if providers lack medical credentialing. The Credentialing ProcessThe credentialing process requires a lot of documentation and an immense amount of accuracy. Oftentimes, payers use the credentialing process to slow down adding your providers to panels. When...

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