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Credentialing and Contracting Services for Healthcare Providers

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Credentialing and contracting are essential processes for healthcare providers aiming to work with insurance payers. Credentialing involves a comprehensive background check by an insurance payer to verify a provider's medical education and licensing. Contracting follows credentialing, which involves agreeing on terms with the payer for reimbursement of services offered to patients within the insurance network. Without successful completion of these processes, providers face financial obstacles and may lose access to a wider patient population, as patients often prefer in-network providers to avoid additional costs. Henry Schein SolutionsHub offers solutions to streamline credentialing and contracting through carefully vetted vendors. Our comprehensive approach ensures that providers can focus on patient care while maintaining healthy financial operations. With the trust of over 7,000 healthcare providers, our peer-reviewed software and solutions are designed to enhance practice efficiency and effectiveness.
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At Henry Schein SolutionsHub, we understand the importance of staying on top of your payer contracts to be sure your practice’s finances stay healthy. For that reason, we’ve carefully vetted the vendors we offer to ensure that you find a partner who will simplify and streamline this important process for you so that you can focus on why you really got into medicine in the first place – your patients.

 

Without having undergone credentialing & contracting with a given insurance payer, a provider cannot receive reimbursement from that payer. For obvious reasons this is detrimental to the practice financially. Additionally, a provider cannot be considered to be “in-network” for an insurance payer without having undergone that payer’s credentialing and contracting process. As many patients refuse to see providers outside of their insurance plan’s network due to the additional cost they face when doing so, this has the capacity to greatly diminish a practice’s potential patient population.

 

Credentialing refers to the process of a clinician undergoing a background check with an insurance payer in order to verify that provider’s education and licensing to practice medicine. Contracting, which takes place once credentialing is completed, involves a clinician signing onto an agreement with an insurance payer under which the provider will be reimbursed for services rendered to patients covered by that insurance company.