Provider Credentialing is the catch-all term that refers to the 3 part process of Credentialing, Enrollment, and Primary Source Verification. Each step of the process represents a time-consuming endeavor for healthcare organizations regardless of their size or expertise.
The importance of provider credentialing can’t be understated because, without accurate and timely completion of this process, providers will not be able to accept payment from government or private insurance companies.
Medical practices, groups, and health systems that leverage WINAXIS’s Provider Credentialing Service remove the administrative burden of first-time credentialing, enrollment, and primary source verification and the ongoing time-suck of keeping these records up to date across the provider’s contracted payers.
WINAXIS handles provider credentialing for all carriers including Medicare and Medicaid.
For Medicare credentialing and enrollment, all activity is managed electronically using the CMS PECOS system using delegated responsibility from the provider or healthcare organization.
Medicaid credentialing and enrollment is a separate process from Medicare credentialing and enrollment. As such, activities are executed digitally as state capabilities and regulations allow.
WINAXIS executes provider credentialing for all commercial carriers like United, Anthem, Aetna, Cigna, Humana, and more.
Practices who use our credentialing service save serious time because they eliminate the burden of managing a separate provider portal for each insurance with which they are contracted.
WINAXIS manages and executes provider credentialing and enrollment digitally as each commercial carrier’s technology capabilities allow.
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