Provider Credentialing

Contracting providers with various payers to be a part of a network of healthcare professionals working with the payers to provide medical services to patients.

Several payers and insurance plans restrict patients to only receive treatment and services from contracted in-network providers with exceptions wherein the patient can choose otherwise depending on provider availability and treatment like emergency services.

Credentialing begins with the payer collating the provider’s information which includes the provider’s qualifications, healthcare certifications and registration, acquired licences and service speciality. Post the necessary verification process, if the information provided satisfies the requirements of the payer, a contract is established with the provider to start treating patients as a contracted provider.