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Credentialing Application
WELCOME TO PROVIDER CREDENTIALING APPLICATION.

WCH Service Bureau - credentialing application eliminates the need for the healthcare provider to complete multiple insurance credentialing applications. From our years of experience in the healthcare industry we know that the importance of provider credentialing lies in the correct submission of a credentialing application, necessary paperwork and tracking provider credentialing applications along with the enrollment process of the insurance credentialing department side. The process of insurance credentialing requires a lot of patience and is time consuming, in which many practitioners may always be available. Our credentialing application is the most efficient and is qualified to handle your credentialing process.

OUR SIMPLIFIED APPROACH – “FILL OUT ONCE - USE ALWAYS AND EVERYWHERE”
  • The application enables to enter your provider credentialing information online.
  • User completes one application/profile rather than multiple insurance credentialing applications.
  • Maintenance of profile is accessed by user id and password.
  • Questions asked on the profile are customized in accordance with the section on the insurance credentialing application.
  • User can jump back and forth between pages.
  • Answer only those questions that correspond to your practice and provider type.
  • Online profile tracks expiration dates of your professional certificates and sends out alerts of upcoming expirations.
  • WCH verifies credentialing application profile and gets in touch with the user for any additional information.
  • Complete profile, select insurances for your practice and let WCH credit you on your behalf.
CAPABILITIES OF THE APPLICATION:

Complete online
Complete online
Modify and preview data on your certificates
Modify and preview data on your certificates
Request paper/HTML/PDF version of your applications submitted application
Request paper/HTML/PDF version of your applications submitted application
Request credentialing application to be added to database
Request credentialing application to be added to database
Print eligibility info directly from the site
Print eligibility info directly from the site
Monitor track dates of your certificates
Monitor track dates of your certificates
Get most up to date insurance credentialing applications
Get most up to date insurance credentialing applications
Track progress of each submitted application
Track progress of each submitted application

Note. If you don't see the required insurance below please contact us.

  1. 1199 Member Choice-Provider Credentialing Application
  2. Allied Health  Professional
  3. Amerigroup
  4. AppOne-Universal Application (Aperture)
  5. Devon Health Services
  6. FidelisCareNY
  7. GHI  Medical Provider Application
  8. Health Plus Physician
  9. HealthProviders
  10. Magnacare
  11. Medicaid Dentist
  12. Medicare Physician NEW
  13. Medicare Reassignment
  14. Medicare-Provider_Supplier Enrollment Application
  15. MetroPlusInc
  16. MultiPlan
  17. New Jersey Medicaid Indiv.
  18. New York Neighborhood
  19. New York Elderplan
  20. New York  Medicaid Group
  21. New York Medicaid Podiatry
  22. New York Medicaid Psychologist
  23. New York Medicaid Therapist
  24. Preferred Individual Practitioner Application
  25. QualCare-Application For Physician Participation
  26. Standard Physician Application Form
  27. Standart Physician Application
  28. The First Health Network
  29. Tricare Provider File Application
FREQUENTLY ASKED QUESTIONS
1. Can you help with credentialing with closed panels?

Absolutely, over the years we have learned to navigate difficult cases such as closed panels. It is true that with thousands of new medical professionals graduating every year, there is not enough space at insurance to credential everyone. Clients that hire WCH team to handle such case are assured that our credentialing specialists will use all available resources: contacts, evaluation of practice location region, database of participating providers in the area and apply our knowledge and expertise to help our clients get into closed panels. Alternative options will be also offered.

2. How long does it take to become a credentialed provider?

WCH is able to complete credentialing process for new providers within 90 days. Established providers that are making any changes, this process is complete within 60 days. Facility enrollment up to 180 days.

3. Can I begin seeing patients without completing the credentialing process with an insurance company?

This depends on the patients’ insurance plan and benefits. Each patient has a specific health plan coverage that delegates the reimbursement and eligibility requirements. Nevertheless, the provider is financially responsible for seeing the patient prior to checking patient benefits and insurance credentialing requirements. From our experience, we can say that the majority of insurance companies prefer to pay contracted providers. Before making your decision speak with us, we can help create timeline and structure so that you get paid for your work.

4. Will I work with specific specialist in the department?

Yes, you will have assigned credentialing specialist that will be the main person for communication between you and insurance company. You will be also able to speak with the department supervisor and manager.

5. What happens if the insurance decides to reject application during final review or reject an appeal?

At any time there is a rejection to an appeal or new enrollment, we don’t stop. Our job is to get our client enrolled with the insurance. There are several steps that can be done to request reconsideration or second level review. We have experience to handle rejected cases in enrollment and second level appeals to help our clients to become accepted by the insurance.

6. How long does the credentialing contract stay active between the insurance and the healthcare provider?

Usually, after approval the contract remains in place for three years, after this period insurances sends requests to confirm practice information. Agreement is only signed once during original credentialing. However, throughout the time of being participating provider, insurance will be sending information to the provider asking to update malpractice, license, DEA, etc. that’s why we have developed annual re-credentialing service to help clients with this paperwork and insurance responds.

7. I am concerned about revalidation, how often it happens?

Revalidation effects every credentialed Medicare and Medicaid provider. Medicare revalidation happens generally every 5 years. Medicaid revalidation takes place every 3 years. Each provider received a notice by mail to revalidate. Also, WCH can help determine your revalidation dates. It’s important not to miss your revalidation date, because this could lead to the contract termination, which will require again to reapply.

8. Can an application submitted guarantee acceptance into the insurance network?

No, submitting application to the insurance does not provide guarantee that insurance will accept provider into the network. Before submitting the application it is important to find out if the panel is open for the provider specialty. Once the confirmation has been received the provider can submit application.

9. Do you recommend joining IPA or seek contracts directly?

Our experience have shown that direct contracts are the best option for providers. However, considering the closure of plans for certain specialties, amount of time it takes to complete one application to join an insurance, IPA sometimes can work better for a practice. However, we consult our clients to always go directly. IPA should be a last resort for healthcare providers.

10. If I have pending malpractice cases, should I disclose to the insurance?

Yes, all pending cases or any type of open/closed case must be disclosed to the insurance company during credentialing process. CAQH must also reflect your most updated information. Supporting documents for each must be attached to demonstrate the details.


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Need Help
Medical Billing Assistance
Phone: (718)934-6714
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Shabbat Time
Shabbat is the seventh day of the Jewish week and a day of rest in Judaism.