provider credentialing services
Working with credentialing payers, WCH supports absolute transparency of credentialing process for providers
We are able to provide a client with statuses for all the opened processes online, 24 hours per day. By request, we also gladly send credentialing reports including all the details and proof of pending or approved cases.
WCH presents results in a timely manner
We are familiar with State Laws and Insurance Regulations. Due to long-term on the job relationships with numerous insurances, we quickly achieve positive results, and our connections are getting stronger as the years pass.
WCH keeps all the records of providers safe
During and after credentialing process, we keep our client's information as non-disclosed for the third parties.
Credentialing services and fees
for individual providers and facilities
We know the rules!
Specialties: your wish is my command;
Professionalism: long-term professional relationships with provider enrolment representatives;
Extra and beyond: Civil Surgeon, Closed Panels, Multistate, License Reinstating and much more;
Trust: Full transparency. Full control and access to your every single application;
Individualized approach: Dedicated employees (Extension, Skype, messaging);
Fees: See prices
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of expertise includes:
Accuracy of medical coding for diagnoses, procedures
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Frequently Asked Questions
Can you help with credentialing with closed panels?Complexities with closed panels are to be settled on a “case-by-case” basis. Over the years, we have learned to navigate difficult cases such as closed panels. It is true that with thousands of new medical professionals graduating every year, there is not enough space at insurance to credential everyone. Clients that hire the WCH team to handle such cases are assured that our credentialing specialists will use all available resources: contacts, evaluation of practice location region, database of participating providers in the area and apply our knowledge and expertise to help our clients get into closed panels.
How long does it take to complete the credentialing process?WCH can complete the credentialing process for new providers within 90 days, for established providers that are making any changes within 60 days, for facility enrollment up to 180 days.
Can I begin seeing patients without completing the credentialing process with an insurance company?It depends on the patients’ insurance plans and benefits. Each patient has a specific health plan coverage that delegates the reimbursement and eligibility requirements. Nevertheless, the provider is financially responsible for seeing the patient before checking patient benefits and insurance credentialing requirements. From our experience, we can say that the majority of insurance companies prefer to pay contracted providers. Talk to us before making your decision. We can help to create a timeline and structure that will give you the possibility to get payments for your work.
Will I work with a specific specialist in the Credentialing Department of WCH?Yes, you will have assigned a credentialing specialist that will be the primary person for communication between you and the insurance company. You will be able to speak with the Credentialing Department Supervisor and Manager.
What happens if the insurance decides to reject application during the final review or reject an appeal?We do not stop even there is a rejection of an appeal or new enrollment. Our job is to get our client enrolled with insurance. Several steps that can be done to request reconsideration or second-level review. We have the experience to handle rejected cases in enrollment and second level appeals to help our clients to become accepted by the insurance.
Can a submitted application guarantee acceptance into the insurance network?No, submitting an application to the insurance does not provide a guarantee that insurance will accept providers into the network. Before submitting the application, it is crucial to find out if the panel is open for the provider specialty. Once the confirmation has been received, the provider can submit an application.
Do you recommend joining IPA or seek contracts directly?Our experience has shown that direct contracts are the best option for providers. However, considering the closure of plans for certain specialties, the amount of time it takes to complete one application to join insurance, IPA sometimes can work better for practice. However, we consult our clients always to go directly. IPA should be a last resort for healthcare providers.
If I have pending malpractice cases, should I disclose to the insurance?Yes, all pending cases or any type of open/closed case must be disclosed to the insurance company during the credentialing process. CAQH must also reflect your most updated information. Supporting documents for each must be attached to demonstrate the details.
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