Credentialing

When you want to participate in health plan networks to treat insured patients and receive in-network reimbursement, you must go through a credentialing and contracting process with each health plan. This process is referred to as “Provider Enrollment“. The process varies by carrier with some initiating the process with a phone call, others have standard forms to be completed, and some require online credentialing applications be completed. There has been some standardization of the process through CAQH, but the process still requires manual intervention and consistent follow-up to ensure it is done correctly and timely.

Physicians Choice^® has developed a standard process for Provider Enrollment that allows its clients to credential once with Physicians Choice^® and then select any number of insurance networks to participate with and have all necessary credentialing information automatically prepared and submitted to desired health plan networks. The Physicians Choice^® process gives its clients the advantage of better turnaround time and access to leading technology throughout the payor credentialing process. Learn more about the Physicians Choice^® process on this page and request a proposal to begin discussing with Physicians Choice^® how our provider enrollment services can improve the efficiency of your organization.

Our team has helped individual providers and medical groups enroll with Medicare and know the application process. Let us save you time and frustration with the ever-changing enrollment process.2

Medicare Provider Enrollment involves submitting the appropriate Medicare Provider/Supplier application forms such as the 855I, 855B, 855S, 855O, and 855A; or utilizing the Medicare Provider Enrollment, Chain, and Ownership System (PECOS). PECOS is an online enrollment system that allows you to make applications or changes to your enrollment record. Medicare Enrollment requirements are very strict, and each state intermediary adheres to a strict standard of compliance for processing enrollment applications.

Our Behavioral Health Credentialing services can help you get in network with the important plans in your market. Physicians choice^® is experienced in working with mental health and behavioral health practitioners to get enrolled in the Medicare program and with commercial insurance plans.

Most commercial insurance plans have separate networks for behavioral health providers. Physicians Choice^® is experienced in working with the specialized mental health and behavioral health networks of insurance carriers and can assist you with the process. Our behavioral health provider enrollment services can save you time and money by handling all the paperwork hassles involved in provider enrollment. Our staff will work as your advocate with the insurance companies to get your application completed as timely as possible.

State Medicaid plans are often difficult to navigate and determine what is required for provider participation. Physicians Choice^® can help you determine the correct enrollment procedure and complete the process to have your providers in-network with your state Medicaid program. Many states have their Medicaid program managed by commercial networks; in which case you also have to enroll with those Medicaid Managed Care Plans. Physicians Choice^® can assist you with getting in-network with all desired Medicaid Managed Care Plans. Call today at 727-300-00630 option 3 or fill out our request for information form to discuss our services.