Starting a new practice or managing an existing one can be tough when credentialing slows you down. That’s where CareSolution MBS comes in. Our credentialing team offers complete credentialing solutions to handle every step of the process from document submission to payer enrollment.
Whether you need insurance credentialing services or full outsourced credentialing, we make sure everything is done accurately and on time. We help providers, clinics, and hospitals stay compliant, get enrolled faster, and keep the revenue flowing smoothly..
We’ve been helping providers and healthcare groups for years, and we know how confusing the credentialing process can get. From credentialing applications to dealing with insurance companies, our credentialing experts handle everything with care and accuracy.
Since credentialing and billing go hand in hand, we integrate our process with AR Recovery Services and Physician Billing Services to keep your revenue cycle strong and consistent.
At CareSolution MBS, we don’t rush through the process, we do it right. Our provider credentialing services and enrollment services are built around your needs, whether you’re running a new practice or managing a large medical group. We follow NCQA and HIPAA standards to keep your information secure and your practice fully compliant.
Since credentialing and billing go hand in hand, our team also provides medical billing services, specialty billing services, and complete revenue cycle management. We make sure your revenue cycle keeps moving smoothly so your payments never get delayed.
In simple words, we take the stress off your shoulders. You focus on patient care — we’ll handle the rest.
We provide full or partial credentialing and enrollment processes for all sizes of medical practices and organisations.. We want to facilitate your moving from your initial hire date to being fully billable. We focus on your application as a story, not just another number tossed in the wind.
Not all patients use Medicaid or Medicare, but they remain at the core of most health practices. Their system does not lend itself to mistake-making — everything must be done precisely as it's needed. A small miscalculation can hang things up, even for months, and that can cost money.
We handle everything for you, including PECOS registration, which can often be a confusing maze. We perform the application configuration, facilitate all follow-up inquiries, and assist in pushing the application through to final approval. We are aware of the exact requirements established by the Centers for Medicare & Medicaid Services (CMS).
The most significant contributor to the top line is the commercial insurers. Contracting with large national and regional payers (e.g., Blue Cross, Aetna, Cigna) is accomplished through various portals, separate agreements, and distinct data requirements.
All our team members specialise in medical billing, so we don’t just enrol you; we ensure the terms of engagement are loaded adequately into your billing system. This is a necessary step to prevent claim rejections after enrollment. We thoroughly review every signature and contract addendum to ensure your practice can bill all major payers your patients depend on.
Privileging is required when a physician wants to admit patients to a hospital or surgery centre, as well as for payer enrollment. This process gives the provider clinical privileges (such as conducting certain surgeries) that can be traced back to a proven skill and expertise.
We partner directly with hospital Medical Staff Management and credentialing departments. We assist providers in navigating the hospital’s time-consuming application process, monitoring required committee reviews, and matching them with a location where they can deliver crucial care within a hospital-based system without delay.
Credentialing does not occur just once, but rather is a continuous process of upkeep and recredentialing. Permitting an enrollment to lapse is among the speediest ways to shut down a significant source of revenue.
We also manage the entire renewal process, so your practice stays in good standing for many years to come. This service also involves tracking, in a proactive manner, the state licenses, DEA certificates, and malpractice insurance that are due to expire.
Occasionally, an insurer may deny a provider’s enrollment or privileges based on its interpretation of the provider’s history or data, regardless of how carefully and correctly the application was completed. When this occurs, he and I need expert help fast.
Our denial management specialist team is available to assist. How we do this: we review the payer's denial letter, create a customised and legally correct appeal, and provide corroborating verification information to quickly reverse the decision. This saves the practice months of revenue that they would never recoup by working with a typical admin team.
We know how confusing and time-consuming credentialing can get. There are so many people involved, providers, payers, and other organizations all needing the right information at the right time. That’s why at CareSolution MBS, we’ve made it simple. Our 4-step credentialing process is designed to keep things organized, easy to track, and always compliant. You don’t have to worry about missing paperwork or long delays. We handle every detail while you focus on caring for your patients.
The preparatory phase involves collecting the necessary data and documents to inform and guide action. We rely on secure systems and custom software tools to collect and organise this information rapidly and accurately. We guide the provider through a first line of information collection—saving them a significant amount of time.
Once we have received all your data, our team will transition to the application process.
We handle 100% of CAQH ProView, setting it up for you, maintaining your profiles, and completing the required daily attestations. Most payers use CAQH as the centralised source of truth. The better your CAQH system is, the quicker you go through the process. We complete and file every application, whether paper or electronic, with your key payers and facilities.
After submitting, comes the waiting game while our work accelerates. This is what the payers call Primary Source Verification (PSV), where they verify the information you submitted against its source (licensing boards, NPI registry, universities).
Our staff is proactive in follow-up; we call payers weekly, sometimes daily, to inquire about the status of your application. We'll take care of all necessary site visits and continue to monitor against federal practice lists to ensure your practice's compliance track record remains protected. The reason is this ongoing "chore" of constantly adjusting it - that's the difference between days and years waiting.
This final step indicates whether the provider is part of a facility network or a staff provider.
We verify the dates of enrollment and guarantee that they want a fully executed contract. We also promptly notify your billing entity of this effective date, so that claims can be submitted promptly. Last but not least, we add the provider to our long-term recredentialing tracking system and create reminders and tasks at each level for the future renewal processes.
What you purchase when entering into a partnership with us is not simply administrative assistance; it’s financial safety and complete compliance. The best medical credentialing company is CARE Resolution MBS because we provide you with quantifiable results that immediately increase your profits.
Our comprehensive solutions cater to the distinct needs of every type and size of healthcare organisation, as well as each provider. We recognise that all groups have unique enrollment and compliance requirements.
We are a Solo Provider and Independent Specialist Physician Credentialing Service. We realise that practices are under growing financial pressure from the outset, through fast, 100% accurate enrollment with all major payers, to ensure their revenue streams are supported from day one. We do the work – from NPI registration to CAQH creation.
With multi-provider groups, we handle both your individual provider enrollment and the practice’s Tax Identification Number (TIN), as it is critical for centralized billing across all of your commercial lines of business. Our staff doesn’t let a provider work until they are credentialed, so there are no delays in care or revenue.
Facility licensure, individual staff privileging, and mass revalidation cycles can be complex for larger organisations to manage. At CareSolution MBS, we deliver the deep experience and systems required to handle these large datasets and applications in accordance with rigorous accreditation standards and national compliance mandates.
Our hospital credentialing and provider credentialing solutions support medical providers, healthcare professionals, and hospitals & healthcare systems in staying compliant and organized throughout the entire process.
These organisations enrol based on specific clinical service codes. We focus on getting their facility applications approved for Medicare and commercial payers, which is essential for receiving payment for diagnostic services delivered to patients.
We also offer our services for mid-level providers (Nurse Practitioners, Physician Assistants) as well as Physical Therapists and Behavioural Health providers. Their enrollment requirements often differ from those of physicians, and we promptly and accurately verify the unique needs of these professionals with all payers.
CareSolution MBS
Credentialing Services Credentialing Code: 5215 Verifying providers' licenses, training, and proving that they have met specific quality standards to bill insurance. This service handles the complex aspects of payer enrollment, healthcare credentialing, and financial compliance for the practice. Our medical provider credentialing solutions help billing companies, insurance plans, and healthcare services maintain accurate provider data and compliance for quality healthcare delivery.
The two main basic types are Initial Credentialing for new insurance network access and Re-credentialing for periodic verification (every two to three years). They are essential functions that payors must perform to ensure compliance and grant billing rights to providers across different healthcare services.
The credentialing process itself is typically composed of four primary "steps" - collecting all necessary documents and information, submitting the application (which is frequently channelled through the regulatory agency CAQH), verifying and follow-up, and actually going through approval and enrollment setup. These steps are part of meeting strict credentialing requirements that ensure healthcare provider credentialing accuracy and smooth integration with insurance networks.
The entire medical provider credentialing procedure typically takes approximately 2 days from start to finish. We minimize the time lost to our providers by focusing on first-pass approval and aggressively managing payer and insurance plan follow-up to maintain quality healthcare flow.
What Documents do you need for provider credentialing? A candidate’s CV, state medical license (original copy), DEA certificate, malpractice insurance (COI with the group name), National Provider Identifier number (Type 1, Type 2), and primary source verification of education. These also need to be correct for regulatory reasons and to ensure compliance across healthcare provider credentialing and insurance networks.
The processing time internally at Medicare can take anywhere from 2 to 3 weeks for new registrations once the application is complete. We prioritise speeding up the vital preparation stage of the day-to-day clock, starting as soon as possible to support providers across healthcare services and billing companies that depend on timely provider data and insurance plan approvals.
