Commercial Credentialing

Commercial credentialing refers to the process whereby businesses get assessed based on their qualifications and competency. There are various ways the business may be credentialed such as through licenses, certifications, assessments, or demonstrating competence of specific software. Commercial credentialing ensures that the business and individuals have the necessary expertise, experience, and financials needed to pursue the business goals.

Commercial credentialing may also include health and safety compliance, financial background checks, legal and government watch list screenings, tax identification, and W-9 verification depending on the nature of the business. Commercial credentialing is most commonly present in the healthcare and insurance industry, whereby commercial healthcare companies have to get credentialed to be included in the insurance provider panel.

Why Is Commercial Credentialing Important?

Commercial credentialing is important because it ensures that the company or vendor is well-equipped and has the necessary professional experience to provide specific business services. Credentialing helps companies to get accredited and become part of a business network or community in their business industry.

Healthcare companies can leverage the commercial credentialing and benefit from being included in insurance panels by charging higher fees or having more customers. This is because credentialing ensures quality in the healthcare service being provided and that patients are being treated with doctors, nurses, or healthcare professionals who possess the necessary skills and experience.

Commercial credentialing is thus a mark of quality and ‘business satisfaction’ which prevents businesses and companies from losing revenue as they can be reimbursed by the insurance companies.

Who Needs Commercial Credentialing Services?

Healthcare companies and individuals who opt for insurance plans may need commercial credentialing services. This is because healthcare companies can enjoy reimbursement from insurance panels for the medical services they provide to their patients.

Individuals who opt for insurance plans may also need commercial credentialing services so that they are deemed to fit the income or health profile of the insurance company. For example, an insurance company may perform credentialing services on an individual and ensure that he does not have any pre-existing medical conditions and has a stable job before admitting the individual into the insurance plan. This is to minimize costs and losses for the insurer as well.

Why Choose KR Billing Solutions?

KR Billing Solutions understand the different requirements for commercial credentialing and how they vary from state to state. Our team is highly experienced and trained in the credentialing process and can guide you and your company to make the credentialing process as smooth as possible. Our staff and team members are onshore and stay fully updated to changing regulations and guidelines with regard to the credentialing process.

If you have any questions about commercial credentialing, you can call us at (855) 978-6499 or send us an email.