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Credentialing and Provider Enrollment



Click to speak to a HBC team member
HBC's team assists with the provider's or facility's enrollment and credentialing process. Our team works with you to obtain all necessary information to fill all requirements set forth by the insurance, hospital or accrediting body.
Full Service Credentialing and Provider enrollment:
Physicians,Practice start-ups, Dentists and other Providers

ASC credentialing
Medicare enrollment services
Hospital Credentialing
Physician Credentialing/Insurance enrollment services
Credentialing maintenance
Medicare and Medicaid
CAQH
NPI Enrollment
Aetna, UHC, BCBS, CIGNA, HUMANA, MHMD, Texan Plus, Payspan and many others



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Forms and Links:
Texas Standardized Credentialing Application link:  https://www.tdi.texas.gov/forms/finmcqa/lhl234.pdf
h6p://www.tdi.texas.gov/forms/form9creden'al.html
Website for CAQH: https://proview.caqh.org/Login/
CAQH Provider Help Desk:Phone: 1-888-599-1771
caqh.@acsgs.com
Question and Answer:
How long does insurance credentialing, contracting and enrollment take?
Insurance credentialing and contracting fluctuates based on the area of the country and the
provider’s unique situation. On average, it takes 90-120 days to become in-network with your
major carriers. Credentialing takes about 60 days and contracting takes another 30-60 days
depending on the carrier. Some carriers may take less or more than outlined time. 

Do Provider Enrollment Services offer credentialing services?
HBC does provide both enrollment and credentialing services. Credentialing is used most of the
time when referencing primary source verification, which is something we perform for health
plans and larger organizations.

How long does the Medicare enrollment take?
Medicare enrollment can take up to 180 days, but our average is around 55 days depending on
what we are doing. Reassignment applications for an enrolled provider take about 40 days.          
The length of times depends on the circumstances of the enrollment and may vary in time and days. 


What is CAQH?
CAQH stands for “The Council for Affordable Quality Healthcare, Inc.”, a not-for-profit 
collaborative alliance of the nation’s leading health plans and networks.
Part of the CAQH’s credentialing database project is the new “Universal Credentialing Data
Source.” This online database collects all provider information necessary for credentialing, and
pulls it together into one database, which is then accessible to the different insurance carriers.

How do I quickly obtain a CAQH ID?
The average for a provider will be 3-4 weeks. HBC’s average time to obtain a CAQH ID is three
days.

Do I need a CAQH ID?
Yes. Most major insurance companies now require CAQH credentialing as the first step in the 
insurance enrollment process.

Does CAQH cost money?
​
CAQH charges the insurance companies and is free for medical providers. HBC charges for the
service to get your CAQH completed quickly and do attestations as needed.

Does my organization need a CAQH ID number?
CAQH numbers are only available to individual providers. Your organization will need a type II
NPI number only.

Does CAQH credential me with the insurance companies?
No. CAQH is simply where the insurance companies obtain their information. You will still need          
to contact the insurance companies and go through their internal credentialing and contracting   

process which can take an additional 90-120 days on average. HBC Credentialing Service is
available and will 
contact insurance companies on your behalf. 
​​

Copyright © 2018 Healthcare Business Connection
  • Home
  • About Us
  • Product | Service
    • Business Development and Marketing
    • CREDENTIALING AND PROVIDER ENROLLMENT
    • CONSULTING AND MANAGEMENT SERVICES
    • HUMAN RESOURCE SERVICES
    • IT MANAGEMENT SERVICES >
      • TECHNOLOGY EMR EHR
    • REVENUE CYCLE MANAGEMENT
    • SEMINARS AND EDUCATIONAL TRAINING >
      • classes
    • Compliance Training >
      • Compliance Login Link
  • Contact
  • Blog
    • Community
    • Newsletter