Before a provider or organization can bill an insurance
carrier, the provider must first be credentialed by the carrier. Credentialing
is the process by which a health insurance carrier formally assesses a
provider’s qualifications and competency based on demonstrated competence. This
can be a time consuming process; here HMS USA INC provider
credentialing services can help their clients by gathering all the requirements
and processing them so that they can save time and resources.
Credentialing and re-credentialing is an ongoing review process to assure the
current competence of practitioners by validating the training and competence
of individual practitioners in particular specialty areas. This level of review
is intended to provide verification that the appropriate training, experience,
qualifications, and ongoing competence has been demonstrated by individual
practitioners for the services they provide.
A team that completes the credentialing details and submits it to commercial
Insurances, Medicare and Medicaid, as requested by healthcare physicians.
Our Credentialing Services ensure compliance with the National Committee for
Quality Assurance (NCQA) and the Department of Health and Family Services
A Dedicated team which handles credentialing services always ensures that all
the matters regarding the service are performed in a proper manner.
Create and update CAQH & PECOS credentialing portals
Issues & Data Integrity:
Our experts perform a proper audit, keeps a keen eye on all the issues raised
while the data is being processed and resolves them at the earliest.