Can A Third Party Help Me With Credentialing?

Third Party
Third Party

Yes, a knowledgeable third party can help you with Credentialing. There are specialized organizations that provide Credentialing & Enrollment services and expertise to assist you in the process of submitting your credentials to Healthcare Organizations, payers, and other regulatory bodies. They can also help you understand the requirements needed for each specific situation, advise on necessary paperwork and provide ongoing support throughout the Credentialing process.

Given the challenges that arise during Credentialing process, it is worth seeking expert assistance. After all, Credentialing has a significant impact on the career of any Healthcare Provider.

Why is Credentialing Important

Credentialing is the process of verifying that an individual meets certain qualifications and standards in order to provide Healthcare Services. It is important to get timely and accurately Credentialed for any Healthcare Provider because it,

  • Provides assurance to patients, payers, and regulatory bodies that Healthcare Professionals meet certain qualifications and standards
  • Increases credibility and helps Providers demonstrate their commitment to quality patient care
  • Enhances Provider’s ability to receive reimbursement from insurance companies 
  • Improves access to care by allowing patients to choose from a wide array of Providers
  • Allows Healthcare organizations to establish and maintain high standards for their staff

What Makes Credentialing Complex?

Credentialing can be a complex and time-consuming process due to the various requirements that must be met to obtain Credentialing. These requirements include background checks, verifications of educational Credentials, licensing verification, submitting paperwork and documentation, and more. Additionally, there may be specific requirements set by each Healthcare Organization or payer that must be met in order to receive Credentialing.

A knowledgeable third party can help make the process of obtaining Credentials easier by providing support and guidance throughout the entire process.

How Can A Third Party Help?

Working with a knowledgeable third party can make the Credentialing process easier and less stressful. A third party credentialing will be able to provide expertise in assessing eligibility requirements for each situation, completing paperwork and submitting documents, as well as providing ongoing support throughout the entire process by,

  • Assessing eligibility requirements specific to each situation – This involves determining if an individual has all of the necessary qualifications and standards that have been established by a Healthcare Organization, payer, or regulatory body in order to provide a service or practice.
  • Completing and submitting the necessary documents and paperwork – This includes providing all of the necessary information, such as educational Credentials, licenses, certifications, background checks, etc., that are required for each Provider to demonstrate their qualifications and receive Credentials. This can be a time-consuming and tedious task.
  • Keeping track of the Credentialing requirements for each payer – This is because there may be different criteria for each provider in order to obtain the necessary Credentials, depending on where the Provider plans on practicing medicine. Keeping up-to-date with these requirements can help make sure that Providers are eligible and compliant with the necessary Credentialing standards.
  • Verifying credentials with state and federal licensing agencies – This involves ensuring that all of a Provider’s credentials are up-to-date, valid, and compliant with any relevant laws or regulations. Verifying Credentials can be an involved process, as it often requires contacting multiple organizations to verify all of the necessary information.
  • Obtaining background checks from designated third parties – This involves verifying that a Provider does not have any history of violations or criminal convictions that would disqualify them from obtaining Credentials to practice in the field they are seeking. Background checks can be conducted through the appropriate state and federal agencies, as well as other third-party vendors who specialize in this type of verification.
  • Monitoring the progress of submitted applications until they are approved/denied – It is important to be aware of the status of an application in order to make sure that it has been properly processed and approved or denied in a timely fashion.
  • Understanding billing requirements and regulations – This involves being aware of the different rules, regulations, and policies that must be followed in order to receive payment for services.
  • Regularly updating credentialing information – This involves making sure that all of a Provider’s Credentials remain valid and up-to-date.
  • Providing ongoing support throughout the entire process – A knowledgeable third-party can provide assistance with this process by monitoring deadlines, offering advice on how to complete necessary steps, and providing detailed reports on a Provider’s progress.

The benefits of third-party credentialing are numerous. Overall, having an experienced third party involved in the Credentialing process can help ensure a successful outcome.


Credentialing is a crucial part of ensuring that Healthcare Organizations, payers and regulatory bodies can trust the quality of services provided by Healthcare Professionals and facilities.

 It is important to have a knowledgeable third-party credentialing expert who understands all aspects of the Credentialing process and can provide support throughout the entire process. This will not only save time but also help to ensure that all requirements are met and that Credentials are obtained in a timely manner.

Given Credentialing can impact your career significantly, it is important to get the right third-party credentialing partner  to assist you. You can learn more about How To Choose The Right Credentialing Partner For Your Healthcare Practice.

For further doubts or assistance, feel free to reach out to Credentialing & Enrollment specialist at Apaana Healthcare.

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