Apex MD Billing

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Credentialing & Enrollment

We are your trustworthy credentialing and enrollment partners, offering up-to-the-mark credentialing services to uplift your practice and let you focus on the bottom line.

Get Your Credentialing Sorted by Our Experts

Your medical billing credentialing is considered the first step toward your medical practice making a mark in the healthcare sector. Without proper and accurate credentialing and enrollment, your healthcare practice is likely to suffer the adverse impacts that can get your practice sued as well. This is why it is high time you find a professional credentialing and enrollment company that not only takes care of all documentation but also provides you with a complete revenue cycle management system for medical billing and coding credentials.

This is why, we at APEX MD Billing LLC, are offering medical practices a complete package when it comes to their credentialing in the revenue cycle process along with proper credentialing and enrollment consultancy for the best results. We have a number of billing and credentialing services available for various types of medical practices. For instance, if you are a psychologist looking for a credible credentialing service, our custom credentialing and billing specialist for psychologists would be highly affordable and cost-effective for you. This will eventually save you a lot of time & money and put you in a position of stability and peace of mind when it comes to focusing on patient care. 

Get In Touch With Us For Cost Effective Medical Billing Services

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    Credentialing and Recredentialing: All Backed Up!

    Credentialing in medical billing isn’t a one-time thing that medical practices can do away with at the beginning of their startup. This is primarily because the services offered by a medical or healthcare practice keep changing and improving time-to-time, along with new updates and legislations being passed by the US government or state governments. To make sure that your credentialing is in line with all legal and ethical requirements, you have to keep re-credentialing and making your practice completely up-to-date with all standards. This is where our credentialing experts at APEX MD Billing can save you from all the hassle and provide you with a backup that’ll eventually manage your credentialing in an up-to-date manner.

    Our Enrollment And Credentialing Services Are Highly Affordable And Cost-Effective. Contact Us Now To Get Started!

    Our Credentialing Experts Are Best in the Game!

    What does it take for one to be a qualified credentialing expert? Well, scientifically speaking, a person has to spend almost 10,000 hours doing a specific job to become an expert in that domain. This is why we, at APEX MD Billing LLC, have some of the most experienced credentialing experts with us in the business. These veterans have spent the major part of their lives with medical billing and credentialing companies, providing both large-scale and small-scale medical providers and healthcare practices with credentialing and recredentialing services to make sure that these practices are serving patients without having to worry about the intricate and hefty documentation processes associated with credentialing and enrollment.

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    Required Details for Credentialing and Enrollment

    Let’s take a look at the necessary requirements for proper credentialing of your practice. Although the essential requirements may vary based on the standards of insurance companies, the most typical ones are the following:

    • Names
    • Gender
    • Race/Ethnicity
    • Home/Mail address
    • Most Recent picture
    • Recent Resume
    • Date of birth
    • Email 
    • Contact Number
    • Information of Citizenship 
    • Social Security number
    • Training, Facilitation, and Education
    • History of Career
    • National Provider Identifier (NPI) number
    • Certification from Board
    • New patient Acceptance
    • Patient age focus
    • Hospital affiliations
    • Medical group affiliation
    • History of claims failure
    • Professional liability insurance Evidence
    • Recent medical education documents
    • References of Peers
    • Practice address
    • Residency
    • Specialties
    • Certificates related to Specialties
    • Qualifications
    • Licensing
    • Practice Tax ID Number
    • Practice Contact number
    • Primary practice contact
    • Disciplinary actions or Sanctions
    • Languages spoken

    Credentialing and Enrollment FAQs

    Fundamentally, credentialing refers to the formal validation of a medical or healthcare provider in a specific private health plan and enabling the provider to get the approval to join the network. On the other hand, the act of enrollment refers to the process through which a provider requests participation in a health insurance network.

    The standard duration to complete the credentialing process takes on average 90 to 120 days. However, if you hire credentialing experts from the billing sector, you can reduce the time frame to less than 90 days as well.


    Privileging includes a health care facility, for instance, a hospital authorizing providers to practice specific kinds of medicine and carry out procedures accordingly on the premises of the facility. As opposed to this, the credentialing process involves regulating and checking the licenses and certificates of the medical providers. The goal here is to check whether the credentials are in good standing or not, and evaluate if the medical practitioner is licensed to practice in the health care facility.

    A credentialed provider in the healthcare sector is someone who has been vetted by insurance companies or networks with all background information along with verification of the required credentials that enables the provider to offer a specific healthcare service in the industry.

    Ready To Talk To Our Credentialing & Enrollment Experts?