MCNA Provider Credentialing Services

The MCNA Credentialing Program outlines the qualifications for becoming a participating provider. The credentialing committee reviews and approves the criteria. The credentialing application lays out all of the requirements in detail. For both initial credentialing and re-credentialing, latest copies of the papers must be provided to the application. These documents will be validated using primary and secondary sources as part of the selection criteria.

Our Credentialing Specialist Will enrolled with MCNA

Long hiring processes, disorganized onboarding, and inconsistent compliance reporting have burdened healthcare providers for far too long. Remote control of these processes is critical for both safety and efficiency.We eliminate many of the problems associated with traditional healthcare sign-up techniques as Credentialing partners, saving your time, money, and stress.

What Makes Us Different From Others

  • Easy Joining Process

Candidates may join up in no time thanks to the user-friendly website, which streamlines the application process.

  • Real-Time Communication And Interaction

The communication between the company and possible candidates is automated, with real-time follow-up emails sent.

  • Easy Document Upload

Scanned papers are uploaded in seconds using simple drag and drop capabilities into a personal profile, where the software automatically recognizes and labels compliance materials.

Who We Work With

  1. Physicians
  2. NPs/PAs
  3. Hospitals
  4. PT/OT/SLP
  5. Podiatrists a
  6. Ambulatory
  7. Urgent Care Centers
  8. Diagnostic Testing
  9. Sleep Research Centers
  10. Orthodontists/Dentists
  11. Optometrists
  12. Audiologists
  13. Behavioral Health Providers

MCNA Application Process

Our application system is built with providers in mind. In fact, two out of three of our application procedures don’t ask for any feedback from the provider. Whether we get data from a client via an API or a provider-filed application, that phase kicks off the process and find the data needed to complete an NCQA-certified credentialing process.

  1. Personal information
  2. Office/practice information
  3. Education
  4. Work history
  5. Professional questionnaire
  6. License to practice and primary source verification
  7. Physician NPI number
  8. DEA license
  9. Physician educational degrees and transcripts
  10. References from previous employers/practitioners
  11. Insurance information
  12. Board certification
  13. Malpractice claims history
  14. Physician License history (suspensions, revocations)
  15. Administration of the MCNA Credentialing Application
  16. Submission of the MCNA Credentialing Applications

CAQH Universal Credentialing

 Observe all reporting requirements

When you use CAQH’s proView service, you may swiftly self-report data that health insurers, hospitals, and other organizations require.

  • Only enter your information once to be credentialed with several insurance
  • Reduce or eliminate duplicative paperwork

Please keep your information up to date

  • If your information changes, you may update it quickly online.
  • Attestation only takes a few minutes and is required every 120 days. -Any organizations you’ve given permission to have access to updated information can do so.

Requirements for re-credentialing must be met

  • It requires practitioners to complete a re-credentialing process every three years.

Re-credentialing

When re-credentialing is due, the Provider System retrieves provider data and loads it into the Provider Database. To collect data, system procedures will be integrated with existing workflows.

Credentialing Committee Appeals

The Credentialing Committee provides an opportunity to appeal if an application is credentialed with limits or refused. An appeal must be filed in writing and examined by the committee within 30 days of the committee’s notification of its decision. Contact the Credentialing department for a copy of the MCNA’s credentialing policies.

MCNA Phone Number

Please call our Network Development Hotline at 1-855-776-6262 if you have any questions or would like to talk with a Network Development Representative.

MCNA Enrollment Email

To join the MCNA network or check the status of a credentialing application, send an email to Provider Enrollment@MCNA.net.

MCNA Credentialing Status

At any point after submitting an application, a member has the right to verify the progress and review and update any incorrect information related to professional qualifications and credentials collected by MCNA in order to assess the credentialing application. The review must take place within one month of the application’s submission date. Within 30 days of the evaluation, any corrections must be addressed.