What is Durable Medical Equipment Credentialing ?

Durable Medical Equipment (DME) refers to items such as oxygen supplies, wheelchairs, iron lungs, catheters, and so on. When launching a High – tech medical Equipment (DME) Company, be prepared with time, money, endurance, and determination, because it all comes down to being paid for the things your company sells. This includes receiving DME bills from clients (patients/healthcare providers), accepting insurance, billing insurance, and lastly obtaining money from the insurance provider for the DME billing. This is referred to as Credentialing for DME.

Credentialing Process

Home of outsource is a major DME Provider Credentialing Services organisation in the United States. Every year, our team of DME Credentialing Experts credential hundreds of DMEPOS Facilities with insurance plans across the country. We have decades of expertise and comprehensive knowledge in accrediting DMEPOS Facilities, and it is our mission to ensure that your DME firm receives the care, attention, and facts it deserves.As a national DME provider credentialing and enrollment firm, our team of DME credentialing specialists has the experience needed to get the job done right the first time. We are delighted to have completed credentialing for over 1 Lac DME providers across the country and would welcome the opportunity to serve you.

HOW DOES IT WORK?

Every year, the WWS team of DME Credentialing Experts enrolls or credentials hundreds of DME providers with insurance plans around the country. Our team of credentialing professionals has decades of experience and will ensure your firm receives the care and attention it needs, whether it is Medicare, Medicaid, the numerous commercial insurance plans, or even the many worker’s compensation networks.

WHAT WE OFFER

• Obtaining the NPI for a Group

• Obtain a Tax Identification Number

• PECOS preparation and re-attestation

• Enrollment and Revalidation of Medicare DME Suppliers

• Setup of Electronic Data Interchange (EDI)

• Enrollment in ERA (Electronic Remittance Advice)

• Enrollment in EFT (Electronic Funds Transfer)

• Changes/updates to addresses

• Payers should be shortlisted and approved.

• Contracts with specific payers and fee schedules should be negotiated.

Our medical credentialing services include the following:

• Enrollment services for physicians and healthcare organisation (credentialing and contracting with health plans).

• Enrollment and re-validation services for Medicare providers.

• Verification of credentials for physicians and allied healthcare practitioners.

• Network administration for health plans.

• Hospital preferential treatment provided by a third party (outsourced medical staff office).

• Contracting for managed care.

• Services for healthcare administration consulting.

• Our staff will work with any insurance companies to enroll your practice providers in health plans and to keep your providers’ credentialing files up to date.

Save time and effort

Our DME credentialing professionals will supply solutions that will create revenue for your DME firm immediately and directly. Additionally, all confidential information and credentialing files must be digitally encrypted, and DME credentialing and re-credentialing services must be accurate, cost-effective, and timely.

Easily Extend Enrollment

House of Outsource is in charge of all parts of DME provider credentialing and re-credentialing, such as:

• Credentialing for all 50 states as well as insurance companies

• Application for enrolment must be completed.

• Enrollment application submission and tracking

• CAQH preparation and ongoing monitoring

• Confirming whether insurance networks accept the provider’s specialization.

• Requesting fee schedules from payers for review and approval by providers prior to contracting

• Documentation archiving for future reference

Starting With Actionable Reporting

Credentialing can be critical to the success of your DME business, especially if you are opening a new location or just starting your DME Company, thanks to WWS’ comprehensive suite of reports that convert provider files into actionable information. Not being able to see clients due to credentialing issues can have a negative impact on your cash flow. As insurance companies reduce provider panels and raise the barrier to entry for DME providers, the peace of mind our credentialing team can provide is invaluable.

The Advantages of Working with House of outsource:

• Years of experience navigating the Medicare and Medicaid provider enrollment, commercial insurance provider enrollment, and other healthcare provider credentialing requirements.

• Status reports keep you informed of the status of your certification.

• Keep all of your credentials in one location.

• You and your medical office staff will be able to focus on more important patient issues rather than enrollment paperwork.

• Credentialing Package from the Joint Commission (All Current Licenses, All Current DEA or CDS, Registration, NPDB, SAM, Board Certification if applicable, etc.).

• Services for collecting applications.

• Finishing the application.

• Paper application data entry

• Services for ongoing monitoring.

• Checks for criminal history.

• Mailing service for applications

FAQ's

How long does it take to get credentialed?

The credentialing procedure takes approximately 90-120 days, however it can be completed faster if all paperwork are complete and there are no objections.

What can I do to expedite my credentialing?

To expedite the credentialing process, you must acquire the necessary documents ahead of time, hire a credentialing services provider, and confirm the accuracy of the information provided.

How long does it take to get a Medicare provider credential?

The beautiful thing about Medicare is that providers can bill from the day they get the application. Medicare usually takes 60 to 90 days to complete the credentialing procedure, but it might take as little as 15 days in some cases.

How long does it take to get a provider credentialed with insurance companies?

Insurance companies require between 60 and 90 days to verify the provider’s educational records, qualifications, previous work experience, and criminal background.

What are the prerequisites for credentialing?

Credentialing is required in order for physicians to be enrolled with an insurance company. Providers cannot seek compensation from insurance companies unless they are credentialed. Credentialing determines a provider’s eligibility.

How long must commercial payers be re-credentialed?

Payers often evaluate provider agreements every three years to verify compliance, and most organisation require compliance with re-credentialing to assure provider network quality.

Why is credentialing so time-consuming?

The accreditation procedure can take up to three months. Every company has a separate method for vetting sign-up applications, and most of the time, an in-house committee scrutinizes the application from every viewpoint.

What exactly is provider credentialing?

When a provider is hired, the process of validating the accuracy of their educational papers, career record, malpractice history, licenses, degrees, certificates, and professional references is known as credentialing. To be paid, providers must be credentialed with payers and insurance companies, and the procedure includes NPI and CAQH ProView.