Credentialing

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Payors we work with

FOR INSURANCE NETWORKS

We provide end-to-end credentialing services

Network Research

We’ll work with you to ensure you have a variety of popular and effective in-network payors to work with. Our experienced team will determine timelines and open-panel availability with the payors of your choice.

Application Filing

We’ll work with you to gather all of the necessary information to file applications. We pride ourselves in our efficiency and thoroughness to ensure a short turnaround time and accurate filing.

Application Follow-Up

Our team will ensure that the submitted application has been received by the payor and that there are no outstanding requests for changes. We follow up regularly with the payor until the contract comes through and arrives at your office or practice.

Appeals for Closed Panels

When needed, we will submit an extensive appeal when there are closed panels for labs of a particular specialty. We communicate your key points of services and overall history of exceptional patient care. We’re prepared for this challenge, as our team has a high success rate of overturned closed panel decisions.

Out of Network Enrollments

When needed, we will submit an extensive appeal when there are closed panels for labs of a particular specialty. We communicate your key points of services and overall history of exceptional patient care. We’re prepared for this challenge, as our team has a high success rate of overturned closed panel decisions.

Demographic Changes

We take care of any documentation required by demographic changes, such as a new Tax ID with your payors, updating addresses, changing bank accounts, and any other necessary tax. We’ll set up all ERA and EFT enrollments, as well.

Annual Credentialing Maintenance

Our credentialing portal manages all of your providers’ and physicians’ credentialing data, and is comprehensive, transparent, and HIPAA-compliant. to ensure we keep your database efficient and accurate.

PECOS and CAQH Set Up and Maintenance

We maintain and manage any PECOS and CAQH profiles that you may use, making sure all information is HIPAA-compliant and accurately profiled.

CREDENTIALING

What We’ll Do for Your Team

Onboarding
Payer Discovery & Application Filing & Submission
Contracting / Fees Schedule / Final Approval
Payer Follow-up on Application
Re-credentialing

Why is credentialing important?

Trust

Credentialing builds trust with leading healthcare insurance companies.

Reimbursement

Proper credentialing ensures accurate reimbursement for services rendered.

Risk Mitigation

Credentialing ensures that providers fulfill requirements and follow rules, which reduces risk.

Financial Stability

Timely credentialing helps to avoid financial losses due to delayed reimbursements / claims.

You Supply the Information, We Do the Work

Insurance Contracting and Credentialing

With our insurance contracting and credentialing service, we help your organization establish contracts with the various insurance companies.

Insurance Contracting
Medical Credentialing

Credentialing

How long does the process take?

Processing time of your application depends on how busy the payor is and also the accuracy of the submitted application. Generally, from our experience we have seen the following timelines:

Private Payors—90-120 business days
Government Payors—120-180 business days
Facilities—120-160 business days

We're a metric-driven company.

We'll provide the following reports, as needed.

Monthly Reports
Provider Enrollment Reports
Provider Credentialing Audit Reports
Credentialing Status Reports
Expiring Credential Reports
Re-Credentialing Reports

We want to see you succeed.

Up-to-date on all HIPPA compliance.

Risk Mitigation

Quality Assurance

Trust and Confidence

Data Security

RCM competitive advantage

RCM customer support and communication

Competitive Advantage

Custom Support and Communication

We use in-house software or any software our customers need us to work on

How our timeline will look together

Contract Signed

Customer signs, and the onboarding process begins.

Discovery Call

Verify open applications with insurances (3-5 days).

Document Request

Collect all necessary documents from the customer.

Application Submission

Submit applications within 2 weeks of contract signing.

Follow-Up

Biweekly updates and regular follow-ups with payors.

Payer Approval

Deliver approved contracts and fee lists to the customer.

Features & Benefits

Improved Quality of Care

Verifies provider qualifications to ensure optimal patient care.

Compliance with Regulations

Meets regulatory standards for exceptional patient care.

Improved Reputation

Enhances provider reputation through high standards of excellence.

Better Financial Performance

Reduces malpractice risks and boosts patient satisfaction.

Facilitation of Provider Networks

Validates provider credentials for consistent and seamless care.

We have high standards for our customers.

Credentialing Application Processing Time

24 hours

Provider Enrollment Time

60-80 Days

Submitted application to pay Accuracy Rate

95%

Credentialing Application Accuracy Rate

98%

Provider Data Accuracy Rate

More than 95%

Provider Satisfaction Score

More than 97%

FAQS

FAQS

Provider credentialing is the process by which healthcare providers join with insurance networks or payers. It is necessary because it enables providers to get paid for the services, they render to patients who are insured by certain payers or networks. Providers could not bill for their services and would not be paid without credentialing.

Partnering with 3DS Healthcare for Provider Credentialing has several advantages, including time and resource savings, reduced administrative burden, accurate and fast credentialing, and increased chances of credentialing success.

• Initial Provider Credentialing (for New Providers)

• Re-credentialing & Re-validation

• Demographic changes

• Maintenance CAQH/NPPES/PECOS

Depending on the payer and the physician’s area of expertise, several documents are needed for provider credentialing. In most cases, providers require copies of their professional licenses, malpractice insurance, NPI (National Provider Identifier), and other supporting records. Providers can get a lot of assistance from 3DS Healthcare in getting ready for the credentialing procedure.

The duration of the provider credentialing process varies based on the provider’ss specialty, region, and payer they are enrolling with. Usually, the procedure takes a few weeks to several months to finish. This could typically take 60 to 120 days, and if the payers are behind schedule, it might take longer.

We try to prevent this from taking place. But, if this occurs because of unanticipated events, we stay connected with the payer on a frequent basis to give you up-to-date information and to attempt to speed up the processing. Our team works carefully to ensure we achieve the finest result possible, no matter how long it takes.

3DS can assist providers in identifying alternative options for credentialing, such as joining other insurance networks or participating in government programs, or helping the providers enrolled as out-of-network providers.

What our customers say

"I have consistently been impressed by the professionalism, efficiency, and precision that 3D Solutions brings to our billing department. 3D Solutions has been crucial in optimizing our billing processes and maximizing revenue collection. Their attention to detail and promptness ensure that no aspect of our accounts is overlooked or delayed, contributing significantly to our financial health and operational efficiency. They are not just about following through but are proactive in identifying potential issues and resolving them swiftly, ensuring that we maintain a high collection rate.

Their team is distinguished by its exceptional work ethic and dedication. They are always diligent and deeply committed to delivering results and enhancing our procedures. This dedication has resulted in consistently high performance in terms of collections and client satisfaction in our dealings. I confidently recommend 3D Solutions as a solid and reliable partner and expert in their field. Any healthcare provider needing top-notch billing and collection services would be well-served by partnering with 3D Solutions."

ChiroMed Healthcare, Inc.
Dr. Jennifer Tinoosh, D.C.

"It is my pleasure to recommend 3D Solution billing service, whom I worked with in the last eight months. During this time, it's been a great experience. Finally, after I have been with two other billing service for several years, I found a service that is the Best fit for my practice.

The service headed by Sam is easy to communicate with, reliable and addresses any issue that arise in a timely and efficient manner. My practice cash flow has grown and has been consistence since I started working with them. I strongly recommend them to colleagues and anybody who need a great billing service".

Dr. Joseph Shoshana

"I write this review to say that working with Paula and Sam with 3D Solutions has been excellent in my opinion.

The beginning started a bit slow, and we had some hiccups to work through, however our office is a bit out of the ordinary and our previous biller left an absolute disaster to clean up. Sam has worked very hard to organize and clean up our process and I must say he is doing a great job. Any questions I have, he always does his best to help. Paula is great to work with and she has not given me any problems that I can think of. We are finally starting to see some light at the end of the tunnel that we have been trying to escape for months and I look forward to continuing our relationship with this team."

Nicholas A. Smith

Industries we work with

Hospital Billing
Physician Group Practices
Medical Laboratories
Skilled Nursing Facilities
Ambulatory Surgical Centers
Durable Medical Equipment
Pharmacy Billing
Tele-Radiology / Telehealth