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Credentialing

Credentialing is the process by which the experience and qualifications of physicians and medical practices are evaluated and validated.  Typically an objective evaluation that takes into account a practice’s licensing, liability claims history, education and training history, credentialing is critical for providers that wish to become part of a payor network.  Credentialing can be an administratively time-consuming task and crucial to the practice’s cash flow if not done properly.

KB Healthcare Consultants offers comprehensive credentialing for all types of physician and hospital owned practices and outpatient surgery centers that are eligible for credentialing with Medicare, Medicaid or commercial insurance.  Our team of credentialing experts can assist with the credentialing for:

  • Commercial Insurance Provider Enrollment and Credentialing (i.e. Aetna, BCBS, CIGNA, Humana, UnitedHealthcare, etc.)
  • Medicare and Medicaid Provider Enrollment and Credentialing
  • Medicare Revalidation
  • CAQH Registration and Revalidation
  • NPI Registration
  • Medicare EFT Enrollment for Individuals and Groups
  • ERA/EFT Set Up Assistance for Commercial Carriers
  • Tracking & Confirmation of all insurance contracts, PAR ID’s & effective dates
  • Weekly or Bi-Weekly Status Reports

To start this process, we will require the completion of a credentialing checklist and supporting documents.  Our credentialing team then provides a weekly update grid to the physician or organization with a status of the payers being credentialed. KB Healthcare Consultants monitors the credentialing process until fully enrolled and credentialed with participating health plans.

To learn more about KB Healthcare Consultants and how we can assist your practice, please contact Kathy Hargreaves, CPA/CFP®/CPC® at  or Johna Kennedy-Preston, CPC at or call at 941-365-4617.

Contact Us

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Our Locations

Sarasota Office
1990 Main Street, Suite 801
Sarasota, FL 34236
Phone: 941.365.4617
Toll Free: 800.966.8676
Fax: 941.954.3207

Lakewood Ranch Office
9423 Town Center Parkway
Lakewood Ranch, FL 34202
Phone: 941.365.4617

Tampa Office
4350 West Cypress Street
Meridian One, Suite 930
Tampa, Fl 33607
Phone: 813.675.8800

Lets Get Started.

 

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