Credentialing and Contracting Services

Why Choose NexaCare Solutions for Credentialing Services?

Credentialing and contracting are fundamental to launching a practice or healthcare facility, forming the basis for your interactions with insurance companies and patients. NexaCare Solutions offers comprehensive credentialing services to hospitals and healthcare systems. We secure and negotiate contracts with insurance payors, ensuring your facility’s or physician’s contracts with insurance carriers are current and beneficial.

Our expertise facilitates your relationships with insurance companies and patients, enabling you to serve more patients effectively and achieve the highest reimbursement rates.

Navigating the Insurance Landscape

According to Forbes, the largest insurance companies in the US by sales include:
Blue Cross Blue Shield
UnitedHealth Group
Anthem
Aetna
Cigna
Humana

Despite the apparent limitation in the number of major insurance companies, NexaCare Solutions can navigate their systems efficiently, providing you with the necessary results. Modern insurance companies cover a broad range of services, including mental health and behavioral health, with fewer restrictions on pre-existing conditions. This makes it easier to meet the diverse needs of your patients.

While insurance companies are closing off their panels and setting high entry barriers, NexaCare Solutions ensures this challenge is effortlessly managed, helping you join your desired network.

Mastering In-Network Contract Negotiations

Effective contract negotiation is crucial in elevating your facility to the desired standard. Our assertive negotiation approach and relationships built over twenty-five years consistently benefit our clients. Poor contract negotiation can result in lost revenue, making it essential to leave this task to experts.

Our Electronic Data Interchange (EDI) team has established strong relationships with network managers in most insurance companies. NexaCare Solutions leverages factors like patient volumes in specific localities to secure the best rates for each physician.

We provide credentialing services to various individual providers and hospitals, ensuring physicians are enrolled in both government and private insurance networks.

Building Long-Lasting Relationships

Medical Billing Credentialing Services

Understanding contract intricacies is vital for maximizing reimbursements, preventing denials, and ensuring a smooth revenue cycle. NexaCare Solutions handles all aspects of the contracting process, including defining and explaining provider reimbursements and arranging healthcare service delivery. We manage negotiations to secure the best rates.

Maintaining contracts with various insurance companies is a challenging aspect of revenue cycle management. Ensuring your contracts provide optimal rates is crucial for financial growth. Proper compensation allows you to better care for your patients and offer necessary services, directly impacting your financial success.

By joining insurance networks, your patient pool increases significantly, as patients typically seek healthcare providers within their network due to high healthcare costs. This availability makes you accessible to more patients across your service area.

However, low reimbursement rates from some networks or plans can affect your revenue. Therefore, effective negotiation is essential when creating your contracts. The more costs you absorb when providing services, the less you can invest in patient care. While patient care is your priority, ensuring optimal revenue is ours.

How NexaCare Solutions Can Assist with Credentialing Services

Credentialing involves extensive back-and-forth communication and documentation, making it a time-consuming process. Instead of hiring a company that only provides credentialing services, choose NexaCare Solutions as your comprehensive partner for all your financial needs. Recognized as one of the most reputable medical billing credentialing service providers in the US, NexaCare Solutions ensures efficient, thorough credentialing that supports your practice’s growth and success.

By partnering with NexaCare Solutions, healthcare providers can focus on delivering exceptional care while we handle the complexities of insurance credentialing, ensuring you are well-positioned to maximize patient care and revenue.