Medical Credentialing Services

Frequently Asked Medical Credentialing Questions

• What is medical credentialing?

  Medical credentialing is defined as the process of obtaining, verifying, and assessing the qualifications of a practitioner to provide care or services in or for a healthcare organization.

• Is credentialing the same as enrollments?

  Enrollments are NOT the same as getting credentialed with an insurance payer. If you are enrolling with a payer you will likely need to already be credentialed with an insurance payer in order for your enrollment to be approved.

  Enrollments are defined as the process of informing your client's insurance company that you plan to submit electronic claims and/or that you wish to receive electronic EOB's or payment reports.

• Do you offer medical credentialing near me?

  Any healthcare provider in the US can take advantage of the InSync credentialing service.

• How long does the credentialing process take?

  Depending on the payer and provider we typically see the process take approximately three to four months. Delays arise when provider packets are not returned in a timely manner and if/when a payer is slow to process an application. 

• What should I expect from InSync's medical credentialing services?

  The process begins with reviewing your specific network needs, or an evaluation of your business needs. The Credentialing team gathers all necessary documents from the provider and contacts the insurance companies to begin the application process. For most companies, the process can be completed online through their portal form. If not, they will be filled out and then sent via the required method. After submitting the applications, timely follow-up with the payers is crucial to ensure they were received. We give weekly status updates to the client to keep them informed throughout the process until an effective date of enrollment is determined and a contract is received and executed, so the provider can begin claim submission.

• Do you offer any services to keep my credentials and contracts renewed?

  As an all-encompassing credentialing service we contact you 90 days prior to the expiration date of the credentialing date. So if your CPR certification is expiring we'll let you know! 

• What set InSync Healthcare Solutions medical credentialing services apart?

  Modern credentialing is far more complex and because of that, the process is also more error prone. At InSync Healthcare Solutions we break down the basics of medical credentialing, the major payers, benefits, best practices, most common issues, and more. We work with all payers, across all 50 U.S. states. We also have experience working with all medical and behavioral specialties and sub-specialties. Every client is assigned a primary point of contact, and we have a reputation for keeping our clients informed about the status of the projects we are working on. We listen, resolve problems promptly, and get results. InSync's focus is making our clients our #1 priority, and truly partnering with them, to become a vital part of their team.