Physician Credentialing Services

Some medical treatments need prior authorization before performing them, so the insurance company can cover the fee. However, precertification takes much time. We are an experienced pre-authorization company and offer valuable prior authorization services.

We help in physicians credentialing services USA, outpatient facilities, and hospitals in the following way.

  • Obtain insurance authorization for services and procedures that need prior approval.
  • Save yourself from the hectic schedule of dealing with the payers and save time.
  • Staff can focus on the primary responsibilities.
  • Get maximum reimbursement


Some Medicare, point-of-service plans and managed care programs need precertification for procedures like outpatient procedures, surgeries, and hospital admissions. The provider can only face significant financial losses if pre-authorization is missing.

We assure you that we will effectively manage the precertification for the procedures. Our prior-authorizations specialists will ensure that:

  • Your submitted claims for treatments or services that require pre-authorization properly
  • Payers’ criteria before submitting a prior authorization request

We ensure that precertification has to apply with the following:

  • The insurance and demographic details of the patient.
  • A verbal/ written order from the physician
  • Referral of the primary care physician to the physician who orders the exam, if needed
  • Detailed diagnosis, past medical history, detailed clinical indications, and the reason for the requested exam
  • Number of sessions expected for stays in hospital and extended care facility stays
  • ICD-10 and CPT codes for planned treatments and diagnostic procedures