GET CREDENTIALED & ENROLLED WITH A PROVEN SYSTEM

Credentialing can be complex and time-consuming, often leading to delays or complications. Many healthcare facilities lack the resources to manage credentialing efficiently and turn to verification organizations for help. Tranquil offers expert guidance to simplify credentialing, enrollment, and licensing processes. Our system & transparent pricing make us a trusted partner in medical credentialing.

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Credentialing specialist with extensive expertise in healthcare provider enrollment

A credentialing specialist with comprehensive expertise

As the go-to credentialing specialists for healthcare organizations, we offer comprehensive services in medical credentialing, enrollment, and licensing. Below is a list of our most commonly requested services:

  • Medicare and Medicaid Provider Enrollment, Credentialing and Revalidation
  • CAQH Registration
  • Commercial Insurance Provider Enrollment (e.g., Aetna, Humana, Anthem, CIGNA, BCBS, UnitedHealthcare)
  • Reimbursement Issues
  • NPI Registration (Type I and Type II)
  • Hospital Privileging & State Licensing
  • Managed Care Contracting Issues

Although we work as a contract credentialing team, we seamlessly integrate with your administrative staff, helping you navigate the credentialing process and achieve successful application outcomes.

Get Credentialed & Enrolled. 2X Faster and Easier!

Credentialing In Medical Practice

Enrollment and credentialing are vital for physicians and dentists to align their billing practices, ensuring optimal payment receipt and uninterrupted service provision to patients. Tranquil Med Solutions manages the enrollment process, handling necessary documentation submissions to maintain up-to-date records for provider organizations’ physicians.

Why Does A Doctors Need Credentialing Services?

To uphold active participation with health plans and ensure patient admitting privileges, prioritizing credentialing is essential. Tranquil Med Solution can aid in the entire process, from new enrollments to re-credentialing and expiry management. Our team manages the necessary paperwork, streamlines the process, and conducts follow-up with insurance companies until completion. With Tranquil Med Solution, you can remain fully enrolled and concentrate on delivering quality care to your patients

THE TRANQUIL ADVANTAGE: YOUR TRUSTED CREDENTIALING PARTNER

Medicare and Medicaid Provider Enrollment

Our services include enrolling providers in Medicare and Medicaid, two of the largest health insurance programs in the US with millions of beneficiaries. By joining these programs, providers can enhance their patient base, increase revenue, and ensure compliance with federal and state regulations.

Medicare and Medicaid provider enrollment services for healthcare professionals
Commercial insurance and IPA's credentialing process in the USA

Commercial Insurance & IPA's Credentialing

We handle the credentialing of providers with commercial insurance payers like Aetna and Humana, which offer diverse plans and networks. By working with these insurers, providers can expand their patient access and negotiate improved reimbursement rates.

NPI Registration (Type 1 & Type 2)

We help individual providers (Type 1) and organizations (Type 2) secure and maintain their National Provider Identifier (NPI). This unique 10-digit number, provided by the Centers for Medicare & Medicaid Services (CMS), is required for all billing, reporting, and electronic transactions.

NPI Registration (Type 1 & Type 2)
CAQH Registration and Maintenance

CAQH Registration and Maintenance

We support providers in setting themselves apart from their competitors. Our credentialing specialists manage and update each provider’s profile on the Council for Affordable Quality Healthcare (CAQH) ProView, an online database for credentialing information. By leveraging CAQH ProView, providers can streamline their credentialing process across multiple health plans.

Revalidation & Re-Credentialing

We handle the revalidation and re-credentialing of each physician’s enrollment and credentialing status with Medicare, Medicaid, and commercial insurers. By entrusting these processes to Tranquil, providers can maintain their program eligibility effortlessly and prevent any disruptions or penalties.

Revalidation & Re-Credentialing
Contract Negotiation

Contract Negotiation

Our credentialing team supports doctors in negotiating contracts with insurance payers, which define the terms of their relationship. This process enables medical practitioners to secure better payment rates, establish effective dispute resolution procedures, set quality benchmarks, and gain inclusion in networks.

Effective insurance enrollment solutions

Managing the complex and often slow insurance credentialing process can be a challenge. Our expert credentialing team streamlines enrollment, helping to optimize your revenue management lifecycle.

Effective insurance enrollment solutions
Reimbursement Issues Audit

Reimbursement Issues Audit

Our specialists in credentialing and privileging investigate reimbursement problems such as underpayments, denials, delays, or errors from insurance payers. We also provide accounts receivable (AR) follow-up services to facilitate the collection of overdue payments. By tackling these reimbursement issues and handling AR, providers can boost their cash flow, decrease bad debt, and refine their revenue cycle.

Credentialing: Did You Know?

1

Start Early

Please note that commercial insurance credentialing and contracting typically take an average of 90 – 120 days. Some plans may have longer processing times,

2

Pay Attention To The Details

With such an extensive process ahead, avoid delays in your implementation by ensuring credentialing applications are submitted with all necessary information.

3

Know Your Key Payers

Identify the payers that constitute 80% of your business to prioritize credentialing for them, ensuring completion of their processes first.

Our Support

We assist physicians, hospitals, healthcare labs, DME companies, and individual providers in increasing revenue from insurance by offering credentialing services. Whether it’s starting a new practice, adding a new physician to an existing group, transitioning practices, or enrolling with a new payer, Tranquil Med Solution’s credentialing service simplifies the payer enrollment process.

Streamline Your Credentialing Needs

PPO, HMO, MEDICAID

FEE Negotiation

Re-credentialing

Demographics Update

CAQH Profile/Maintenance

Fee Schedule Updation

EDI/ERA/EFT Setup

Insurance web logins

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Complete Payer Support

Enroll With Your Favorite Payer Through Tranquil

Government Payers

That instance – Medicare, Medicaid, and TRICARE.

Commercial Payers

That instance – Blue Cross Blue Shield, Kaiser Permanente, Anthem, United Healthcare, Aetna, Cigna, and Humana