Credentialing

Credentialing is a process whereby hospitals, health insurance companies and health delivery systems (HMOs) evaluate physicians with whom they contract, to confirm that they are adequately trained, certified and / or licensed to provide care.

A typical healthcare provider contracts with 10 to 20 healthcare organizations, each of which requires the provider to complete an extensive credentialing application.

One of the most integral parts of the credentialing process is the collection and verification of vital data regarding the healthcare provider's education, training, experience, practice history, location, and disclosure of any issues impacting their ability to provide care.

After submitting the application, carriers often take as much as 3-4 months to review documents and make a determination, even if everything is in order. If there are errors, missing information or a question about submitted documentation, several more weeks or even months can be added to the process.

Insurance / Clearinghouse Credentialing

Let Fedora take over this very time-consuming process. We have a staff specialized in medical / healthcare insurance enrollment & credentialing. 

Our singular focus is to eliminate errors, foresee potential obstacles, and avoid delays getting you on the insurance panel of a participating provider, and most of all keeping you current.  We prepare each form with meticulous attention, and submit the proper paperwork, adhering to each insurance company’s application processing criteria.

Our Data Source enables providers to submit one standard credentialing application to satisfy the credentialing requirements of most insurance companies.

We guarantee the confidentiality and security of the provider information. The FSPL Data Source is designed to be compliant with rules and regulations related to the privacy of individually identifiable health information.

NPI Registry

We also help physician obtain a NPI.  NPI ( National Provider Identifier ) is a unique 10-digit identification number issued to health care providers by the Centers for Medicare and Medicaid Services (CMS).

According to HIPAA, providers must share their NPI with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes.  Any delay in obtaining a NPI, will risk your cash flow and that of your health care partners as well.

  • "We have been working with Fedora Solutions for almost two years now. I must say they have been a tremendous help in working with our numerous accounts. Since they have been working with us we have been able to remain timely with our patient's accounts. I want to thank all staff members for their hard work and the many hours they have put into helping us." - Evelyn Rangel
    Account Rep
  • "I have been working with Fedora Solutions staff for the last couple of years and they have been a big help with our billing and any question we have. They are quick to respond by email or phone and they are always willing to help in anyway they can and a pleasure to work with."- Tammie Ambriz
    Insurance Supervisor
  • "It has been a great pleasure to work with Fedora Solutions for the last two years.  They have learned every aspect of our billing department and have been a tremendous help in keeping our business current.  They have taken on everything we have given them & helped keep pace with our expanding practice."- Sandra Wheeler
    Payment Coordinator
  • "It has been my pleasure to work closely with staff at Fedora for several years. The staff and Fedora are friendly and has been a great asset to our companys success. The staff at Fedora are extremely knowledgeable and are quick to solve problems such as coding and billing issues and the appeals process in the event a claim has been denied. I look forward to many more years working with Fedora and their highly trained staff."- Cynthia Hukill
    Account Rep