Optimize Your Provider
Credential Service with
Superior Medical Billing
Provider Credentialing Made Easy with SMBT Fast-Track Enrollment in Premium Payer Networks
Credentialing, or insurance credentialing, verifies the qualifications, skills, and legitimacy of healthcare providers. This essential process ensures providers have the required licenses, certifications, and education to offer healthcare services while meeting state and federal compliance standards. Only credentialed providers are eligible for payer reimbursements and network inclusion.
Credentialing grants access to facilities and insurance networks such as Medicare, Medicaid, Aetna, Cigna, Humana, UnitedHealthcare, and Blue Cross Blue Shield. Fast and accurate credentialing is vital for providers to start practicing and billing legally, but the process can be complex, requiring meticulous documentation and verification. Errors can lead to delays, denials, and resource wastage.
SMBT offers comprehensive credentialing services, managing every step from primary source verification to enrollment in top-tier payer networks. We deliver fast, reliable, and cost-effective solutions, so you can focus on patient care.
Priority Reimbursement Advantage
Secure top-tier reimbursement rates, ensuring higher payouts for your services. Boost your revenue and enhance satisfaction with streamlined financial rewards.
Exclusive Privileges for Your Practice
Our efficient process secures vital contracts and privileges, enabling you to join innovative programs and earn performance-based incentives that boost your practice's success.
Billing-Ready from Day One
Start submitting claims immediately with a unique provider identification number (PIN). Save time with seamless electronic claim submissions and real-time tracking.
Swift Reimbursements
Experience faster claim processing, ensuring steady cash flow for your practice. Payments are typically processed within 15 to 30 days, eliminating lengthy waiting periods.
Insurance Advocacy
We represent your interests with insurance providers, addressing concerns, negotiating terms, and resolving disputes to guarantee fair and timely payments for your services.
Reduce Denials
Say goodbye to denials with our expert support. We ensure accurate claims, verify eligibility, and secure authorizations, streamlining your process and maximizing efficiency.
We Secure Access to Valuable In-Network
Contracts for Providers
SMBT provider enrollment services secure in-network contracts, regardless of how exclusive the payer panel may be.
- Provider Advocacy
- Partner with insurers
- premium networks
- Hospital privileges
Our Streamlined Credentialing Process
A Step-by-Step Guide to Our Proven Provider Credentialing System
At SMBT, our credentialing process goes beyond routine procedures. We follow a certified, compliant approach that ensures providers meet the highest industry standards. With a 98% success rate in securing approval for providers in premium payer networks, we maximize privileges in your specialty. Here’s a look at our efficient process:
Provider Survey & Data Collection
Our credentialing journey starts with an in-depth survey led by our specialists. Through detailed interviews, we collect vital information such as license numbers, educational background, demographic details, and professional experience.
CAQH Enrollment & Management
We handle CAQH application submissions, manage ProView accounts, and keep credentials up to date for seamless primary source verification. Our team also supports payer credentialing submissions, ensuring fast insurance panel integration and accurate profiles that improve network participation and patient care quality.
Selecting the Right Insurance Partners
Our medical credentialing services assist providers in strategically choosing insurance companies that align with their practice goals and license type, while also selecting the best insurance panels based on practice location.
In-Network Enrollment Made Simple
After credentialing, we guide your application through the contract phase, securing in-network agreements with fee schedules and eligible CPT codes. We tackle closed panel challenges with strategic appeals, ensuring your inclusion. Enjoy direct billing and preferred reimbursement rates as an in-network provider.
Securing Your Hospital Privileges
Once credentialing is complete, we continue supporting you by facilitating applications for essential hospital privileges, including admitting, courtesy, and surgical rights.
Credentialing Maintenance Made Simple
Our continuous oversight ensures that your company’s credentials remain current and that you stay credentialed without interruption. Our experts diligently track your credentialing expirations and conduct comprehensive daily and weekly reviews to maintain your active status. You can rest easy knowing that your credentials are in good hands with us.
Continuous Credentialing Oversight
We ensure your credentials stay up to date and compliant without interruptions. Our team monitors expirations, conducts regular reviews, and proactively updates your records for seamless credentialing management.
Comprehensive Credentialing Services
Streamlined Solutions for All Your Credentialing Needs
SMBT provides end-to-end credentialing and enrollment support for healthcare professionals and organizations. Explore our full range of services designed to simplify the process and ensure success:
Medicare & Medicaid Enrollment
Expand your patient base and revenue by joining the largest U.S. health insurance programs. Our team ensures seamless enrollment, helping providers meet federal and state regulations while serving millions of Americans.
Commercial Insurance Credentialing
Gain access to more patients and secure better reimbursement rates by credentialing with top private insurers like Aetna and Humana. Our expertise helps you navigate the complexities of commercial payer networks.
NPI Registration Made Easy
Whether you’re an individual provider (Type 1) or an organization (Type 2), we assist in obtaining and updating your National Provider Identifier (NPI). This essential 10-digit ID ensures compliance for billing, reporting, and electronic transactions.
CAQH ProView Registration and Management
Our experts manage and maintain your provider profile on the Council for Affordable Quality Healthcare (CAQH) ProView. This online database simplifies credentialing by verifying provider information across multiple health plans, boosting your credibility and appeal to payers.
Medicare DMEPOS Enrollment
We assist providers in enrolling in the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) program. This allows you to offer essential items like wheelchairs, braces, and diabetic supplies to Medicare patients, enhancing care quality and ensuring reimbursements.
Hospital Privileges Support
Our team secures and renews hospital privileges for physicians, enabling them to admit, treat, and collaborate within hospital facilities. With these privileges, you can access valuable resources, build professional relationships, and expand patient care opportunities.
Contract Negotiation
Our credentialing specialists empower healthcare providers to secure optimal agreements with insurance payers. Through skillful negotiation, practitioners can achieve better payment rates, clear dispute resolution terms, inclusion in networks, and compliance with quality measures.
Revalidation & Re-Credentialing
We simplify the revalidation and re-credentialing processes for physicians, ensuring continuous enrollment with Medicare, Medicaid, and commercial insurers. Our team manages these renewals proactively to prevent service interruptions or penalties, keeping providers eligible and compliant.
Reimbursement Issues Audit
Our experts audit and resolve reimbursement issues such as underpayments, claim denials, and processing delays. With thorough accounts receivable (AR) follow-up, we help providers recover outstanding payments, enhance cash flow, and optimize revenue cycles effortlessly.
Provider State License
We guide providers through obtaining and renewing their state medical licenses, ensuring compliance with state-specific regulations. This helps practitioners demonstrate their qualifications, adhere to legal standards, and safeguard their professional credibility.
DEA Certification & Renewal
Our credentialing experts streamline the process of obtaining and renewing DEA certificates, enabling providers to legally prescribe controlled substances. This ensures safe and lawful medication management for patients.
CLIA Registration
We assist providers in registering laboratories under the Clinical Laboratory Improvement Amendments (CLIA), ensuring compliance with federal standards for diagnostic testing. CLIA certification supports high-quality laboratory practices essential for accurate patient care.
Top-Rated Provider Credentialing Services Across the USA
Partner with SMBT for expert credentialing solutions available nationwide, ensuring seamless compliance and network enrollment.
SMBT specializes in provider credentialing solutions tailored to meet your unique practice needs. With over a decade of experience, we support healthcare organizations across all 50 states in the USA, ensuring compliance with payer and state-specific requirements.
Our process begins with a thorough assessment of your needs, followed by compiling, verifying, and submitting critical documents such as licenses, certifications, and insurance coverage. Leveraging strong relationships with payers, we help streamline credentialing for efficient approval.
For example, credentialing in California involves verifying licenses with the Medical Board, reviewing malpractice insurance, and submitting profiles to networks like Blue Shield of California.
SMBT also offers specialized services, including re-credentialing, expedited processing, and locum tenens credentialing, making us your comprehensive partner for enrollment and compliance needs
Payer Enrollment and Credentialing
Services for Healthcare Providers
Streamlined Credentialing for Healthcare Organizations
Accurate credentialing is key to delivering quality care, attracting patients, and ensuring compliance. Our all-encompassing service simplifies the credentialing process for providers across all specialties. We offer payer enrollment and credentialing services for:
Streamlined Credentialing for Physicians
Our service ensures physicians quickly join insurance networks, enabling seamless patient care while enhancing credibility and trust with patients and peers.
PAs and NPs Credentialing
Streamline credentialing for Physician Assistants (PAs) and Nurse Practitioners (NPs) with our expert services. We help expand their practice scope, ensuring they’re authorized to deliver critical medical care independently and compliantly.
Hospitals
Our credentialing services enhance hospital efficiency by streamlining insurance claims processing and fostering collaboration across medical staff, ensuring smoother operations and improved patient care.
PT/OT/SLP
Our credentialing services empower physical, occupational, and speech therapists to join insurance networks, enabling them to provide essential rehabilitation services while ensuring consistent revenue streams.
Podiatrists (DPM)
Our credentialing services support podiatrists in gaining recognition within insurance networks, allowing them to provide specialized foot care and strengthen their standing as trusted experts in their field.
Chiropractors (DC)
Our credentialing services enhance chiropractors’ integration into insurance networks, ensuring greater access to patients and solidifying their role as vital contributors to holistic healthcare.
Ambulatory Surgery Centers (ASC)
Our credentialing services help ASCs build patient confidence by showcasing compliance with stringent quality standards, essential for delivering safe and effective surgical care.
Urgent Care Facility Credentialing
We streamline credentialing to ensure your urgent care facility is in-network with insurers, enhancing access to timely and affordable care for a wider patient base.
Diagnostic Testing Facility Credentialing
Our credentialing services help diagnostic facilities and clinical labs secure insurance approval, driving patient referrals and ensuring timely diagnosis and treatment.
Optometrist & Audiologist Credentialing
Our credentialing services expand the reach of optometrists and audiologists, enabling them to provide vital eye and ear care to a broader range of patients.
Behavioral Health Provider Credentialing
We assist behavioral health providers in joining insurance networks, ensuring critical mental health services are accessible to those who need them most.
Comprehensive Payer Enrollment
Seamlessly enroll with your preferred payer through SMBT.
Government Payer Enrollment
We assist with enrollment for government payers, including Medicare, Medicaid, and TRICARE.
Commercial Payer Enrollment
We handle enrollment with leading commercial payers, including Blue Cross Blue Shield, Kaiser Permanente, Anthem, United Healthcare, Aetna, Cigna, and Humana.
Our Service packages
SMBT Provider Credentialing Solutions
Basic
- Credentialing
- Enrollment
- Support
- Billing
- EHR
- Gather and validate all necessary documents and information.
- Prepare and submit applications and forms to your selected payers.
- Track progress and follow up until approvals and contracts are secured.
- Provide regular updates on your credentialing status.
- Issue your credentialing certification upon completion.
Advanced
- Credentialing
- Enrollment
- Support
- Billing
- EHR
- Verify and attest to your information on payer portals as needed.
- Manage your CAQH profile, Availity account, and Optum ID.
- Update your documents and information promptly when required.
- Handle periodic re-credentialing and re-enrollment.
- Ensure compliance with all relevant rules and regulations.
- Monitor and adapt to changes in payer requirements and policies.
Premium
- Credentialing
- Enrollment
- Support
- Billing
- EHR
- Offer a tailored, specialty-specific EHR system for your practice.
- Provide training for you and your staff on using the EHR system effectively.
- Integrate the EHR system seamlessly with payer portals.
- Manage all aspects of your medical billing processes.
- Optimize your revenue cycle management for maximum efficiency.
- Perform claim scrubbing and denial management to reduce errors and delays.
- Provide 24/7 dedicated support to address any issues promptly.
Simplify Your Credentialing Process with Ease
Credentialing doesn’t have to slow you down. With our expertise, tools, and industry connections, we’ll handle the process and get you credentialed and enrolled with any payer you choose. Regardless of your specialty or location, we’ll help you access the full benefits of being in-network!
