Credentialing & Enrollment

Empowering Providers Through Efficient, Compliant Credentialing Solutions

Medical credentialing is the foundation of a provider's ability to deliver care and receive reimbursement. At Intercon RCM Partners, credentialing process is built to help providers achieve in-network status efficiently and compliantly, whether you're a solo practitioner or a multi-provider organization. We help simplify payer enrollment and reduce administrative delays, ensuring you're ready to deliver care—and get reimbursed.
🔐 HIPAA and HITECH Compliant Processes. Your data is secure and your credentialing is audit-ready.

Why Choose Us?

Credentialing for 50+ insurance payers

Support for solo, group, and multispecialty practices

HIPAA/HITECH secure data handling

Real-time status updates & proactive follow-ups

Full-service contract negotiation (in-network)

🔍 What is Medical Credentialing?

Medical credentialing—also known as provider enrollment—is the process of verifying a provider's qualifications, licensure, training, and background. It is required for both in-network participation and out-of-network billing across medical, behavioral, and telehealth practices.

Credentialing is essential to:
• Gain in-network status with major payers
• Ensure compliance with state and federal standards
• Protect patient safety and service quality
• Secure timely insurance reimbursements

📈 Success Metric:
“Credentialing turnaround reduced by 30% with Intercon RCM Partners, leading to faster patient onboarding and accelerated cash flow.”

Why Credentialing
Matters

Credentialing Process: Step-by-Step

Document Preparation

We gather and verify all required documentation: o Medical licenses & board certifications.... o Work & education history............. o Malpractice coverage.................... o References & hospital privileges

Credentialing Application Submission

We submit complete, payer-ready applications to minimize rejections and speed up processing.

Primary Source Verification

Insurance companies validate credentials with issuing institutions—education, licensure, and employment.

Deficiency Resolution

We proactively resolve application gaps or missing information to avoid unnecessary delays.

Payer Review & Approval

We manage communication and follow-ups with payers to ensure applications move smoothly.

Contracting & Enrollment (In-Network)

For in-network status, we assist with contract negotiation and agreement reviews.

Ongoing Maintenance & Re-Credentialing

Regular updates for licenses, insurance, and credentials to keep your profile active and compliant.

Credentialing Type

In-Network

Out-of-Network

Overview

In-Network Formal contracting with insurance plans at pre-negotiated reimbursement rates. - Higher patient volume - Streamlined billing - Better patient affordability

Credentialed without formal payer contracts; can still treat and bill patients.

Value to Providers

- Higher patient volume
- Streamlined billing
- Better patient affordability

- Greater fee flexibility
- Fewer contractual restrictions

Proven Results for Our Clients

• 20% Faster Payments: On average, our clients experience 20% faster payments after partnering with us, helping to accelerate their cash flow.

• 30% Reduction in Claim Denials: By addressing the root causes of denials and improving the accuracy of claims, our clients typically see a 30% reduction in claim denials within the first 6 months of working with us.

We provide tailored credentialing solutions based on your practice area:

Ready to Get Started?

Let us handle the paperwork so you can focus on patients. Contact us for a free consultation and customized credentialing plan tailored to your practice.