Provider Credentialing Services FAQ's

Explore provider credentialing services frequently asked questions and understand how RCM Centric help healthcare providers in their practice billing. Get rid of your credentialing woes and get enrolled with great efficiency. Our highly experienced team manage everything and process applications with correct information.

Credentialing Services FAQ's

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Medical Billing FAQ's

Get answers related to our healthcare medical billng services and process in details.

Medical Coding FAQ's

Get answers related to our healthcare medical coding services and process in details.

Credentialing FAQ's

Get answers related to our provider credentialing and enrollment services and process.

Patient Help Desk FAQ's

Get answers related to our PHD (Patient Help Desk) solution for each medical practice.

Provider credentialing is the process through which an insurance company judges the qualifications and competence of a healthcare provider. Before you can be reimbursed by a patient’s health insurance company for the services you provide, you first need to be credentialed by that insurance company and pass their credentialing requirements.

The provider credentialing application process requires documentation, and lots of it. Healthcare providers give the insurance company access to relevant records, reports, certifications, identifications, and more. The insurance company or insurance panel then reviews these documents to assess whether or not the participating provider is fit to provide patient care services to its clients. If the insurance company deems the provider qualified and competent, they award a credential.

The Council for Affordable Quality Healthcare, or CAQH, is an organization that has developed a solution to one of the most time-consuming aspects of the provider credentialing process.

Although the provider credentialing process doesn’t come with any shortcuts, there are best practices you can employ to ensure the process doesn’t slow down. Delays can kill your productivity. Here are a few things you can do to avoid them:

  • Submit every document that’s requested 
  • If something doesn’t apply to you, make sure you write “not applicable” 
  • Don’t skip any questions and answer everything thoroughly 
  • Use the format that is requested for things like dates and phone numbers 
  • Make sure your CV is comprehensive and up to date with no gaps in years 
  • Don’t forget to include a copy of your Controlled Dangerous Substances certificate  

Many providers choose to get credentialed by several different insurance companies so that they can expand their patient base, deliver more services, and earn more money. Each of those individual insurance companies require their own credentialing process.

Even if you choose to only be credentialed with one insurance company, you will still need to get credentialed more than once. This is because providers need to be re-credentialed at least every three years by law, in order to continue practicing.

We have credentialed healthcare providers of more types than we can list: from chiropractors, to behavioral health providers, to surgeons. If you are eligible to be credentialed, we can get you credentialed!
If you are fully licensed, we should have no problem identifying plenty of insurance companies and third party payers for you to be credentialed with. In some areas, some panels can be very selective or closed. In these instances, we will talk with you about the likelihood of a successful credentialing process. We want you to get the most out of your credentialing investment!
Healthcare providers need to be credentialed at least every three years. Some healthcare facilities or insurance companies perform recredentialing even more often.
Yes, once physical therapists credentialed with any insurance provider will get all in-network payment benefits.

• Free EHR integration
• File storage cloud account
• Real-time financial reporting
• Accurate electronic claims submission and tracking
• Daily billing and follow-up
• Quick payment turnaround
• Claims re-submission for identifying lost dollars
• Weekly and monthly reporting
• Secure web log-in
• Online financial reports
• Practice analysis
• Cash register/IOU
• Customized office forms available online 24/7:
• Hospital Super bills
• Office Super bills
• Registration Forms
• Sign-in Sheets

RCM Centric handles all medical specialties including Cardiology, Neurology, Internal Medicine, Family Practice, Pain Management, Podiatry, Neuropathy, Gastroenterology, Anesthesia, Psychiatry, Surgery, Dermatology/Plastic Surgery, Cosmetic Surgery, ER, Allergy and Immunology, Pulmonary, Radiology, Interventional Radiology, Orthopedic, Pediatrics, Ophthalmology, Infectious Disease, Gynecology, Rehab, Nephrology, Thoracic Surgery, Endocrinology and much more. See a complete list of our medical specialities.

Communication between RCM Centric and their clients is of primary importance. After signing a contract with RCM Centric, each physician receives an email address and secures web log-in identification for sending and receiving messages. Our Customer Support staff is also available to answer questions and ensure satisfaction, while our Patient Help Desk is available to handle insurance related inquiries or patient calls.

Our direct submitters are spread across all states in the USA.

There are no extra charges for electronic claims transmission. In fact, no auxiliary charges are incurred for any of RCM Centric’s services. We do not maintain a standard “module mentality” of charging physicians on an a la carte basis for each additional service they utilize.

All checks and EOBs will be sent directly to your office. Since most insurance companies offer ERA and electronic versions of EOBs, and EFTs (Electronic Funds Transfer), physicians can receive EOBs and payments faster than a standard paper delivery, allowing the follow-up process to be expedient and efficient. For physical copies, just keep the checks and send us scanned copies of the EOBs.

After signing the contract, we can begin the setup process immediately. Generally, for most physicians, the process takes 2 to 3 days. We can provide an accurate estimate after reviewing your individual practice.

Forms with missing information are uploaded in a Pending Transactions List (PTL), which may be accessed by your secure web log-in. You will be able to review and update any missing information. This information is instantaneously imported into our system, avoiding any delays for claim submission.

We are a team of medical coders, billers and RCM specialist working in this field since 2008. Our team structure is unique and professional to provide all services at high standard priority so each client can work with us smoothly.

We provide services to all healthcare providers within United States. We are covering each state and expending our services for all regions.

YES, we have our Patient Help Desk to communicate with your patients regarding their bills or any information about the visits. Our Patient Help Desk can schedule appointments with your patient, reminders, follow-up, notice or any further inquiries.

YES, once you contracted with us, we will assign you a dedicated account manager with a team of expert billers and coders who will work on your Practice / Account.

We mostly send weekly and monthly customized reporting to the clients about the collections, outstanding, balances, claims or any updates.

Yes, our data migration teams work closely with new customers to ensure a smooth transition. We provide the necessary templates to your former billing company so that they can compile data in a format that is compatible with our system. After receiving data in the required format, we will import it into our platform for you, completely free of charge.

Don’t hesitate to contact the sales team and schedule an appointment for 15-30 minutes; our team will assist you accordingly. If you need quick help, call us at (415) 530-2893 or email us at [email protected].