Credentialing & Audit

Insurance Credentialing

Insurance Credentialing, also called medical or physician credentialing; Physicians and other healthcare practitioners who wish to bill an insurance company and receive reimbursement for services as an in-network provider must undergo a process of credentialing in which the insurance company verifies the providers education, training, experience, and competency and assign a specific provider number to the application.

When You Need Credentialing

New Provider
So you’re a new provider, and you’re ready to see your first patient. Not so fast! If you plan to accept insurance, you must credential with most insurance companies to receive reimbursement. We will help you credentialing and contract with the insurance companies of your choice.
Starting a New Practice
Maybe you were credentialed and contracted with your previous company. So many providers assume the credentialing and contracts will follow them to their new practice. This simply is not true. When a provider changes tax-id, often times new contracts will need to be obtained. If you change states, the credentialing must start from the beginning in the new state, if for national insurance companies. We can help get you credentialed and obtain new contracts under the new tax-id or your social security number.
Adding a New Providers
Your practice is growing, and you need to add providers. Some insurance companies will require group contracts for practices with more than one provider. Each provider will need to be credentialed and either added to the group contract, or have an individual contact that will pay to the practice tax-id. We can help make sure each provider has completed the necessary application and contracts to ensure your practice is paid for services rendered.
New Insurance Company
At some point, your practice may decide to accept new insurance payers. This will require establishing contracts with the new insurance company. We can help you establish contracts and review the fee schedule for the new insurance company.

How It Works

Sign Up
Sign up for credentialing service by accepting a formal services agreement and BAA (Business Associate Agreement) which comply with HIPAA
Data Collection
We collect all pre-requisites from physicians for filing credentialing application to insurances using HIPAA compliant platforms such as FTP etc.
Submit Application
We Submit the completed credentialing applications to insurances and save a copy of it for future references for each insurance.
Follow up
We call to insurance carriers on regular basis to track the status of application, provide insurance carriers additional information right away if demanded.
Get provider Number
We obtains contracts and provider number from insurances with effective date and communicate to provider or billing staff.

Where We can help

NPI New Application
NPI Update
State License Application and Renewal
DEA application and Renewal
CAQH creation and maintenance including re-attestation and documents submission
Medicare Enrollment
Medicaid Enrollment
Insurance Credentialing and Re-credentialing
Hospital Privileges

FREE AUDIT SERVICE

In today’s complex healthcare environment, Aizan simplifies revenue management across multiple practices with our modernized approach, We cater to independent practices’ unique needs, making billing and payments seamless, Our streamlined processes create a convenient revenue cycle, allowing you to focus on delivering care, Partnering with us ensures an easy, eFicient billing process, enhancing your practice’s financial stability, ket us assist you by handling these complexities while you concentrate on other aspects of the business.

Modernized Medical Billing Solutions:

AZ modernizes medical billing to streamline your practice’s workflow with services like charge entry, claim submission, eligibility & benefit verification, prior authorization, Payment Posting, Denial Management and AR. keveraging cloud-based platforms, we ensure accurate reimbursements and operational eFiciency, Our expert team stays compliant with industry standards, ensuring data security and real-time visibility into your financial performance.

The Purpose of Our Free Billing Audit:

Our free audit service aims to provide our clients with a detailed assessment of their medical billing processes, identifying errors, ineFiciencies, and areas for improvement, By pinpointing coding inaccuracies, documentation gaps, and potential revenue cycle bottlenecks, we oFer tailored solutions to optimize your practice’s financial operations, This comprehensive evaluation helps streamline billing processes, enhance cash flow, and ensure compliance with regulatory standards, ultimately enabling healthcare providers to focus more eFectively on delivering quality patient care.

Benefits of the Free Audit

Billing Accuracy
Detailed analysis of coding accuracy and documentation completeness to reduce errors and maximize reimbursements.
Improved Revenue Cycle
Identification of strategies to streamline claim denials and payment delays, optimizing your revenue cycle
Cost Savings
Insights into potential cost-saving opportunities through more eFicient billing practices and reduced errors.
Peace of Mind
Assurance that your billing practices are compliant with regulatory standards such as HIPAA and CMS guidelines
No Obligation
Receive a comprehensive audit report at no cost, with the option to discuss findings and explore further services without commitment.
Expert Consultation
Opportunity to consult with experienced billing professionals to clarify findings and discuss potential solutions.
Customized Recommendations
Personalized suggestions tailored to meet the specific needs and goals of your practice.
Testimonials

How our services bring about success