Pinnacle Medical Resource Medical Credentialing


What if a panel that i want to be on is closed?  

                                       


If one of the  panels tells us it is closed, the first thing we will do is submit an appeal. The insurance company will either formally deny your request and we have to seek out another panel, or the company will push your application through anyway so you can finish the credentialing process. Sometimes, just a bit of persistence on our part is all that is needed to make insurance companies reconsider your request, and we always exercise very option at our disposal before moving on to another panel. 


What if all of my panels are closed?                                                      


The chance of all of your panels being clo

sed is slim to none. As we said earlier, even if a panel does claim that it is closed. persistence on our part is generally enough to push through the closed door and get on the panel of your choice. 


Will I be able to track the progress of my credentialing?      

 

You can track your credentialing process, you can call us and we can check the process for you. As we said earlier, whether you take on credentialing yourself or if you allow to do it for you, credentialing is a process that does involve playing the waiting game, so chances are you will not receive an update daily. however, we will be contacting you each and every time we receive an update on your credentialing process, and you are always free to contact us with questions. 


What is the process of medical credentialing?                              

 

 If  you choose Pinnacle Medical Resource medical credentialing to do your consulting for you, we take 3 simple steps:

1. Together, we identify which insurance panels works best for you. Example HMO, PPO, MSO (Centers Specific) Workers compensations, International, etc. 

2. We provide you with a survey to complete. This survey contains all of the basic information that insurance companies will need when considering your request. 

3. Using your survey, we contact the insurance panels of your choosing, we retrieve instead of spending hours completing and submitting paperwork and following up with insurance companies, you can spend your days giving your clients the excellent care they deserve


Which insurance panels are the best for me?                                 


First, you'll want to consider a few larger panels, such as Blue Cross Blue Shield, Tricare, Humana, Nationwide, United Health Care, and others. Secondly, you may want to consider being on a few smaller, more region-specific panels unique to  your area. 

Maintains a large database, complete with information about panels in your area as well as the applications for those panels. If you don't contact us with certain panels in mind, we are more than happy to help you decide which ones are best for you. 


How long does medical credentialing take?                             


Typically, the credentialing process take between 60 to 120 business days, or 3 to 4 month. This time frame can be relative to the panels you choose- some panels take a smaller amount of time, while other panels may require more information and therefore may take longer to respond to your request. Medical credentialing is a process that does involve some waiting, so it is wise to plan ahead with this in mind.


About how many hours of work will medical credentialing require?                                                


Dedicated an enormous amount of time to credentialing our providers. On average, credentialing a client on one panel take 10 hours of work. So, if you applied for 10 insurance panels, we would dedicate 100 hours of work on your credentialing process alone. 




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Am I guaranteed to get on the panels of my choice?                  

 

We often know at the very beginning of the process whether or not a panel is going to accept your request or not. If you are denied, we can do two things 1. We can make an appeal to the insurance company on your behalf, or 2. We can get you credentialed with a comparable panel. Either way, you won't lose out if a panel denies your request. 



Grow your practice, call now : 786-363-0207