We Take the Pain Out of Credentialing

Medical credentialing is the process of authenticating the qualifications of licensed medical professionals to assess their experience, education, competency, and training for legitimacy, and it is vital for physicians and other healthcare practitioners who must bill insurance companies to receive compensation for their services. Health care institutions and provider networks oftentimes may conduct their own credentialing through credentialing specialists or credentialing committees. Credentialing can sometimes include granting or reviewing special clinical privileges for physicians or other healthcare practitioners.

Who We Are

At Horizon Office Technologies, we understand the importance of maintaining your good standing credentials at all of your affiliated institutions. Because being compensated is important to keep your medical business functioning, we are here to help simplify the process of physician credentialing management. We understand that medical practices come in many different sizes and offer different specialties, and we have medical credentialing packages to suit the needs of the business side of your medical practice.

What We Do

Because we understand the medical credentialing process, we know what you need to get started and remain in good standing. All physicians and other healthcare practitioners who bill insurance companies in order to receive reimbursement for services must undergo the credentialing process. The process includes a credentialing application detailing providers’ training and qualifications to treat patients within their specialties. The National Committee on Quality Assurance (NCQA) sets the standards for credentialing. Some of the review criteria includes:

• Education
• Board Certification
• Work History
• State License, current
• Malpractice Insurance, current
• DEA License, current
• Clinical Privileges
• Sanction History
• Claims History

After receiving all of your information, insurance companies, however, must also determine whether providers meet their internal qualifications to serve as a healthcare provider to their insured customers. Once a provider’s credentials have been approved, the insurance company issues a participating provider contract that allows provider with services to bill the insurance company and receive reimbursement as an in-network provider.

How We Help

At Horizon Office Technologies, we understand the importance of insurance reimbursements to your business’ bottom line. We work with you and your staff to ensure that your credentialing needs are met so your medical business can reach financial success. Whether you are a single physician location with only one affiliation or you are a multiple practitioner location with many affiliations, Horizon Office Technology’s staff is here to support your credentialing needs and ensure regulatory compliance. With Horizon Office Technology’s simple credentialing maintenance processes working for your business, you can keep the focus where it needs to be: on your patients.

At Horizon Office Technologies, we take the hassle out of the credentialing process for you, and we work to ensure that your credentials remain in current standing. As physician advocates, our challenge is to help you find a way to manage the everchanging and growing administrative side of your medical practice so that you can get back to doing what you do best: practicing medicine.

Our Medical Credentialing Solutions

Although the size of your medical practice determines the level of credentialing services you and your staff need to maintain, we know you don’t want to pay for more than you need. Because of that fact, our highly-trained staff will work with you to ensure your requirements are met by one of our credentialing packages. All of our credentialing and maintenance packages include:

• Application completion
• Plan approval verification
• Change of office or payment address
• Contract delivery

For larger practices, locations transitioning from single-physician practices to group practices or other group practices, we offer the following services:

• Single office location with multiple affiliations
• Single practitioner to group practice transition
• Application and coordination for Physician Hospital Organization (PHO) or Independent Practice Association (IPA)
• Ancillary service agreements
• Direct contracts with multiple plans
• Hospitals with pending privileges

Our full-credentialing packages incorporate all of our services, including:

• Multiple new practitioners
• Multiple office locations
• Unlimited practitioner credentialing
• Multiple hospitals with pending privileges
• Application and coordination for multiple PHO/IPA
• Tax ID changes on established contracts

Why Choose Horizon for Medical Credentialing Services

At Horizon Office Technologies, we understand that not all medical practices are the same, and we do not offer a one-size-fits-all solution. Because your medical practice is unique, we offer three credentialing packages and credentialing maintenance services to suit your practice’s needs. For a small fee, our devoted and highly-trained staff will maintain your credentials and remind you of deadlines and updates to ensure that your contracts and licenses stay current and your practice stays compliant with regulations.

To start making your credentialing process less stressful for you and your staff, call us today at (224) 238-4200 or complete our secure information form. Our highly-trained staff is ready to help your practice now!