Nurse Credentialing Services

Nurse credentialing is the process of establishing the qualifications of licensed medical professional of nurse practitioner and assessing their background and legitimacy. Nurse practitioners conduct their own credentialing, generally through a credentialing company, nurse credentialing specialist or electronic service, with review by a credentialing committee. Instant medical billing nurse credentialing process includes granting and reviewing specific clinical privileges, streamlines the sharing of verified digital credentials between nurse practitioners, and healthcare organizations to eliminate onboarding and deployment delays while empowering data-driven decisions for better networks and care collaboration.

Credentialing Process

• Background checking and screening for drugs are critical aspects of the procedure of authorization.

• When all required documents are obtained, they are maintained in a guarded corporate registered office and sent to client facilities using a secure system.

• The maintenance of the files includes updating and adding proof of ongoing educational credits as they’re accumulated regularly with current certificates and licenses.

• In order to comply with the credential criteria of each accrediting body, procedures are done in addition to updating each customer facility with the latest paperwork for each licensed provider. Surgical institutions generally select one of several national accrediting bodies. These include the Ambulatory Health Care Accreditation Association (AAAHC), the Ambulatory Surgical Accreditation Association of the United States (AAASF), and the Joint Committee. Each company has its own distinct set of supplier credential standards to be satisfied and managed.

Benefits of nursing Credentialing

• Progress in career

• Respond to businesses’ requirements by minimizing red tape

• Unique skillsets are identified

• Identify a major or highly desired knowledge base

• Ensure that patients have satisfied the practice standards

• Prove the commitment of a nurse to your job

• Give a nurse a sense of career achievement

Benefits of Outsourcing Nurse Practitioners Credentialing

House of outsourcing uses the latest technology andsecure credentialing process to get enrolled nursepractitioners on time. Our nurse practitioners will receive the following benefits by outsourcing credentialing to Instant Medical Billing.

Our Data Runs Deep

Our medical nurse practitioners credentialing team uses millions of data point proactively curated daily from hundreds of sources to make the credentialing process accurate and smooth. Our unique provider insights make the process fast.

Intelligent Automation

We believe that accurate data processing provides a positive result. Hence our data-enabled learning continuously identifies patterns of efficiency that produce reliable, repeatable results that inform all network decisions.

Monitoring & Maintenance

We monitor and maintain all your provider documents, expires, and C.E. credits.

Hospital Privileges

We handle the lengthy application process required for obtaining authorization to deliver care at a healthcare facility.

New Technology

Our solutions streamline both the initial hospital credentialing process and ongoing hospital credentialing maintenance and can be utilized internally or externally.

Why Nursing credential important?

Insurance acceptability is Mandatory

Medical approval is important for nurses regardless of whether they start or maintain a practice. Although many veteran healthcare providers have successfully practiced cash-only, they now feel that it is necessary to obtain medical approval. It is important to have insurance panels or to network with insured plans because health care in the country is available more universally (insurance panels allow practitioners to accept new and potential patients’ payments from third parties, a component of the practice’s growth.

Covered Patient Services Application

Many practitioners who have previously accepted cash-only payments now provide insurance plans to more people due to health reform. Healthcare costs are on the increase. HMO planning has gained prominence over PPO planning, leading to obsolete non-network benefits. Furthermore, healthcare has been made fairer and allows services to cover new or preexisting conditions.

Today, patients do not hesitate to wonder whether they accept their insurance – they actually require them. Patients were in the past willing to pay the doctors, chiropractors, mental health workers and other health care professionals outside of their pocket for services. They want to ensure that their health care is paid by the insurance company, given the increasing costs of health premiums. For health care providers to stay with the current market, it is important that they accept insurance and do not want to be excluded from attracting new patients. This requires registering or receiving credentials in insurance plans.

Why Choose Us Medical Billing for your Hospital Credentialing?

We have a database of over 1 million healthcare service providers includes 95% of all U.S. MD’s and D.O.’s, as well as dentists, podiatrists, Chiropractors, Nurses, psychiatrists, social workers, and therapists.

• 30+ years’ experience

• 1 million Application transactions

• More than 1 million providers

• Profiling primary source verified data

• National accreditation with URAC & NCQA

• 4000+ unique healthcare documents & applications

• Full services CVO credentialing

• Provider reimbursement evaluations

• Network recruiting

• Full web-based reporting

• We offer CVO and Provider Enrollment Services

• 96% of all M.D.& D.O. in the nation are in our database

• Simpler universal credentialing to speed up approvals

• Hospitals can know which vendors are on-site at any time

• Commercial Payer Enrollment

• Medicare Enrollment

• Medicaid Enrollment

• CAQH Enrollment

• Primary Source Verification

• Provider Maintenance

• Hospital Privileges

• Hospital Credentialing

• CME Tracking & Notifications

What Information is required for Nurse credentialing?

We have a qualified, experienced team of medical credentialing experts and web-based secure technology; our credentialing experts need the following Information from hospitals.

• License to practice and primary source verification

• Physician NPI number

• DEA license

• Physician, Nurse Physician, work history

• Physician educational degrees and transcripts

• References from previous employers/practitioners

• Insurance information

• Board certification

• Malpractice claims history

• Physician License history (suspensions, revocations)

• Administration of the Hospital Credentialing Application

• Submission of the Hospital Credentialing Applications

9 Steps to Attaining Nurse Practitioner Credentials

• Select and apply a certification board

• Send verification credentials information

• Take the test

• Official certification received

• Request a nursing license with the State Nursing Board (BON)

• Receive a state license BON

• DEA certificate application

• Request for a certificate of controlled harmful substances

• Request a number for NPI

FAQ’s:

Q3: What steps must be taken to complete credentialing?

(1) You must complete the application completely. If you do not complete the application entirely or if additional Information is required, a representative from the House of Outsourcing will contact you. It is critical that you respond to those requests as soon as possible, or we will be unable to process your application.
(2) House of Outsourcing cross-checks specific data points with the “primary source.” That includes the state licensing board, your professional training/education, and so on.
(3) Once the source verification is complete, your application is presented to a committee of your peers, who will decide whether or not you meet our requirements.
(4) If your application is approved, you will end up receiving a welcome packet and guidelines in the mail.

Q2: How long will it take for my application to be processed?

House Of Outsourcing aims to complete credentialing applications in 60 days or less. This could take longer if you submit an incomplete application or do not include requested attachments with your application.

Q3: How frequently do providers need to be re-credentialed?

Providers must renew their credentialing every three years, beginning with the date of their initial credentialing (unless their state has other requirements). To remain a participating provider, a provider must successfully pass re-credentialing.

Q4: What happens during the re-credentialing process?

After about two and a half years in the network, you will be notified for re-credentialing. Your specialty specific instructions will be included in the notification. You may not even need to take any action at the time of re-credentialing if your application is on CAQH and is kept up to date.

Q5: What if the Credentialing Committee rejects either my initial participation application or my re-credentialing application?

Depending on the reasons for the committee’s decision, you may be given the option to provide additional Information and file an appeal. Your denial or termination letter will explain your rights as well as the timelines you must adhere to.

Q6: Can I submit a state application in the state where I practice?

True. House Of Outsourcing follows all of the state-mandated application guidelines.

Q7: What exactly is a National Provider Identification Number (NPI), and where can I get one?

NPI stands for National Provider Identification (NPI). If you are unsure how to obtain an NPI, you should contact your state licensing board to learn more.

Q8: What exactly is a CV, and is it required?

CV stands for curriculum vitae. It’s similar to a resume in that it includes a summary of your educational background, work history, professional license, and any other special training you’ve received. You are not required to submit a CV to the House of Outsourcing. Instead, fill out the application questions.

Q9: My credentialing application was denied due to a lack of information, according to a letter I received. What should I do?

You must follow the instructions provided. If you have any questions, please contact the person who made the request. Respond to these requests as soon as possible so that House Of Outsourcing can continue processing your application.

Q10: Why do I have to send you the same Information for re-credentialing every time?

House of outsourcing will obtain the Information from CAQH if you have a CAQH application and have kept it up to date. You must submit a CAQH application if you have not already done so. After you have completed the application, you must keep the records up to date. In addition, if your clinic is accredited as an organization, you must submit a separate “group” credentialing application.

Q11: I'm not sure why I was rejected (or terminated) access to the network?

The letter you received should have a name and a phone number where you can get more information.