Medical Credentialing Services

Your Trusted Partner In Compliance, Credentialing & Enrollment

Ensure your healthcare organization continues to provide the highest level of care without delays and unnecessary stress with the help of Neolytix provider credentialing and enrollment services.

Advanced Credentialing Solutions for Modern Healthcare Providers

Managing credentialing within a large healthcare organization is a complex, burdensome, and resource-hungry task. The extensive number of individuals and entities involved amplifies the complexity, requiring coordination, meeting regulatory standards, and adapting to personnel changes.

Neolytix offers provider credentialing services tailored to the needs of healthcare organizations. Our comprehensive services include automated verification processes, real-time status updates, and personalized support to streamline your operations, saving you time and resources while ensuring compliance and accuracy.

medical credentialing services

Your Technology-enabled, Full-Service Solution

Having holistic control of compliance within your organization mitigates the risk of non-compliance and operational disruptions. Neolytix CVO offers customizable solutions to larger healthcare organizations that empower them to manage the complexity of running an efficient and compliant operation to the benefit of the bottom line and patient care.  

Licensing Service

Enjoy expedited licensing support to prevent service gridlock, to scale your healthcare business or to expand your telehealth services, ensuring timely approvals and building a qualified and compliant workforce.

  • Physician Licensing
  • Non-Physician Licensing
  • DEA Licensing
  • CDS Licensing
  • CLIA Licensing
  • Group Licensing

Primary Source Verification (PSV)

Leveraging cutting-edge technology and industry expertise, Neolytix CVO streamlines the verification process, providing healthcare organizations with a reliable solution to uphold compliance, enhance patient safety, and maintain the highest standards in credentialing.

  • OIG, AMA, AOA, ABMS, ABIM
  • Federal and State DEA certificates
  • State medical licenses
  • Education Credentials
  • Board Certifications
  • Internship, Residency, etc
  • State Controlled Substance Registration
  • Training programs

Provider Onboarding Portal

Neolytix's inCredibly™ is a proprietary platform tailored to streamline the onboarding process for larger healthcare organizations. This innovative solution ensures swift and compliant onboarding of new providers, leveraging advanced features to enhance efficiency and accuracy throughout the entire onboarding journey.

  • Azure Enterprise-Class Secure Cloud
  • Real-Time Status Updates
  • Expiration Alerts
  • Secured Document Storage
  • Automated Workflows
  • Pre-populated Forms Library

Credentialing & Enrollment

Ensure your healthcare organization continues to provide the highest level of care while remaining compliant with Neolytix CVOs provider credentialing & enrollment solutions.

  • Recommendations on the most popular and effective in-network commercial insurance mix for your group or practice and help with the credentialing and contracting process.
  • Out of Network enrolments - Our team helps with NPI registrations on the Payer's websites.
  • Requests for appeals on sometimes closed panels - 35% success rate.
  • Automated workflows ensure all applications are followed up regularly.
  • Update a new TAX ID, address changes, bank account, set-up of ERA and EFT enrollments.
  • Maintain active providers and expiration management in a secured application.
  • We maintain and update your CAQH, PECOS profiles, making sure all information is accurate.

Privilege Management Service

A comprehensive solution designed to simplify and optimize the intricate process of managing privileges within healthcare organizations. Our advanced platform ensures efficient oversight, compliance, and seamless administration of provider privileges, contributing to a robust and secure healthcare environment.

Make informed decisions using data you can trust. Neolytix expedites and simplifies the privilege approval process for board members by providing the necessary information quickly through our proprietary technology and optimized processes.

Transform Your Credentialing Process with Technology

Neolytix CVO’s proprietary platform inCredibly puts large healthcare organizations in the driver’s seat of seamless credentialing. The Continuous Learning Platform is changing how hospitals and clinics handle credentialing processes with yearly updates. Here’s why:
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Simplify Data Entry

Our platform is designed for effortless data entry, minimizing complexity, and saving time.

Intelligent Document Management

Leverage intelligent document management features to organize and access crucial credentialing documents efficiently.

Reduce Manual Errors

Minimize the risk of errors with automated processes, ensuring accuracy and compliance in your data.

Faster Time to Credential

Accelerate the credentialing timeline, allowing providers to start serving patients promptly.

Pre-built & Custom Reports

Access pre-built reports for quick insights or customize reports to meet your specific needs.

No Upfront Cost

Get all the advantages of our platform without paying upfront, saving money.

Tailored Solutions for Healthcare Organizations

Catering to larger healthcare organizations means being able to offer agility to adapt to their changing demands fast. After 12 years of servicing healthcare organizations nationwide, we have refined our offerings to cater to the diverse needs of our clients.

physician credentialing services

Start your credentialing journey with Neolytix’s CVO service. We handle new applications, demographic changes, portal verification, and maintain CAQH and PECOS.

This solution is efficient and comprehensive, designed for simplicity, and priced per transaction with a minimum commitment of $1,000.

Optimize your credentialing experience with a dedicated team exclusively committed to your Provider Onboarding, Primary Source Verification, Credentialing, Enrollment, and Maintenance needs.

This solution allows you to choose a customized scope that aligns with your specific requirements. With a commitment of at least 1 full-time equivalent (FTE), ensure a dedicated and efficient approach to your credentialing processes.

Elevate your credentialing capabilities with Neolytix CVO’s Analytics & Automation capabilities.

This option makes your credentialing processes more advanced by providing custom reports for Management Dashboards using Power BI & Dataverse.

Benefit from seamless integration with EHRs like EPIC, eCW, Athena, AMD, ensuring a streamlined and efficient experience. Choose Neolytix for enhanced analytics and automation, transforming your credentialing insights into actionable intelligence.

Credentialing Expertise Across Diverse Specialties

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Strengthen Your Revenue Cycle with
Neolytix's Services

Contact us to learn about our services, including Contract Negotiation and Medical Licensing. These services help increase your organization’s revenue from reimbursements.

dea-certificate

DEA Certificate & Renewal

clia-registration

CLIA Registration

cds-licensing

CDS Licensing

group-licensing

Group Licensing

provider-licensing

Providers State Licensing

reimbursement-audits

Reimbursement Audits

healthcare-recruitment

Healthcare Recruitment

Be Process-Ready and Prevent Disruptions

Use our comprehensive checklist to gather the necessary information and minimize errors. This will help you overcome the obstacles and slip past the red tape to make the credentialing and enrollment process smoother.

Why Choose Neolytix for Physician Credentialing Services?

Our physician credentialing services streamline the process, ensuring your practitioners are appropriately licensed, verified, and enrolled in insurance networks. Our solutions help you focus on giving good care while we handle the credentialing paperwork.

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12+ Years Nationwide Experience

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Efficient Provider Network Expansion

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Round-The-Clock Availability

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Scalable Services

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RPA & API Proficiency

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Flexible Pricing Options

TESTIMONIALS

Listen to what our clients
have to say

Sarah Charmchi
Sarah Charmchi
2023-06-13
I chose Neolytix for credentialing our practice. The team was knowledgeable, responsive and kind and supported us through the process. I would certainly recommend their services.
Sue Robbins
Sue Robbins
2022-07-23
Neolytix has helped so much with our outstanding A/R. They are always so very willing to help and complete the task in a timely manner.
Toby
Toby
2022-07-18
We transitioned to Neolytix a while back, having come from a billing company we were less than thrilled about. The people here have been very responsive to our needs and requests, and adapt quickly to whatever curve balls our practice throws them. They bring a wealth of knowledge to the table, and take the attitude that our success is their success.
Sandy M
Sandy M
2022-07-15
I was a new office manager for a private practice when I hired Neolytix for credentialing assistance. Eden has been very thorough and helpful every step of the way. insurance credentialing can be so overwhelming at times, that having this task off my plate has given me a peace of mind. I know she is handling everything. Always quick to respond to questions or concerns.
Cheryl Lambert
Cheryl Lambert
2022-07-10
Neolytix is the most professional and hard working billing company I have ever been partners with . I call them a partner because they truly are. Neolytix makes sure what they bill is accurate. Their knowledge of physician billing is outstanding. The entire team takes control and does what is necessary to make sure you get paid.
Priti Patel
Priti Patel
2022-07-09
I habe hired a virtual assistant through Neolytix and she is amazing. The team has trained her well so I didn't have to deal with that aspect so I can focus on running my clinic. She is fast and responsive to clinic tasks. Patients have said positive things about her as well.The team at Neolytix did well...I just wish I would have signed up sooner 😅

Frequently Asked Questions (FAQ’s)

Physician credentialing is the process of verifying a healthcare provider’s qualifications, credentials, and work history. This is done to ensure they meet the standards set by regulatory bodies, healthcare organizations, and insurance companies.

Although there might be deviations in the information requirements typically as per the insurance plans, the following is required:

  • NPI Number
  • CAQH profile (up-to-date)
  • Practice information (Address, etc.)
  • Medical License
  • DEA license (If applicable)
  • License to practice and primary source verification
  • License history
  • Insurance information
  • Education: degrees and transcripts
  • Board certification
  • Detailed Work history
  • References (Previous employers/practitioners)
  • Malpractice claims history (Revocations, suspensions, etc)
  • Malpractice Insurance
  • Insurance login details (Medicaid, Medicare (Pecos), Availity etc.)
  1. Verify NPI Registry for correct information and taxonomy. 
  2. Check CAQH profile, ensure documentation is up-to-date and re-attested. 
  3. Confirm with insurance if group/provider is contracted with requested payor. 
  4. Fill out appropriate paperwork to get provider/group contracted. 
  5. Review all paperwork carefully before submitting the application. 
  6. Submit the application to the payor to complete the contracting process. 
  7. Follow up every 2-3 weeks to ensure timely processing  
  8. Informing providers on credentialing process approval 
  9. Facilitate contract execution between the provider and Insurance enrollment plan.  
  10. Confirm the effective date of in-network is the same or as close as possible to the initial request date.

The expected duration of the provider credentialing process can vary depending on various factors, such as the complexity of the application, the number of providers being credentialed, and the responsiveness of third-party organizations involved in the process. However, on average, the provider credentialing process can take anywhere from 60 to 90 to even 120 days. Outsourcing to a reliable  service provider can shorten the duration of the process efficiently and effectively.

Yes, having a service location is a crucial component of the credentialing. Insurance companies typically require providers to have a physical service location where they deliver healthcare services. This is where patients can contact the provider and show the provider’s presence in the community.

 

When you start the credentialing process, you must give information about where you work, like the address and contact details. The insurance companies use this information to verify your eligibility and to ensure that you are accessible to patients seeking healthcare services. Having a well-defined service location is, therefore, an essential prerequisite for starting the credentialing journey.

It can vary based on your services, the people you serve, and location. When choosing insurance companies, consider their network size, plan options, reimbursement rates, and credentialing requirements.

It’s generally a good idea to start with the largest insurance companies in your area, as they tend to have the largest patient networks and offer the most coverage options. However, you should also consider other factors such as their plans, repayment terms, and approval process.

These additional aspects are important to take into account when making a decision. It is crucial to evaluate the plans offered by the company and determine if they align with your needs and goals. Additionally, understanding the repayment terms is essential to ensure you can comfortably meet the financial obligations. Lastly, assessing the ease of approval can save you time and effort in the application process.

You can hire a specialist company like Neolytix to handle provider enrollment (including Medicare enrollment) for you to help lessen at least one of the burdens of practice management.

Credentialing is about joining insurance panels to bill as an in-network provider for medical or insurance purposes. Primary Source Verification is the process of checking a provider’s credentials directly with the original source.

Healthcare organizations must verify the authenticity of degrees, work experience certifications, and licenses. This is necessary to prevent liability caused by providers using fraudulent methods. For instance, using fake degrees or falsifying resumes to get employment poses a significant threat to healthcare organizations. To prevent risks, healthcare organizations require doctors and providers to verify their credentials before hiring them.

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