Anthem Provider Credentialing Services
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How Will Our Experts Assist You During The Process?
What We Do To Help You
- It will save you months of time and effort
- Removes aches and pains produced by large numbers of printed materials and applications
- Boosts patient referrals
- Insurance firms pay out more quickly
- Assigns a project manager to your venture
- Makes phone calls, follows up on them, and presents all applications, texts, and emails
- Access to online project portals is available at all times
- Give you a cost-competitive advantage to help your practice expand
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What Information is Necessary for Credentialing?
The information varies according to the payer, however, it is generally consistent across the board and normally includes.
- A History of Malpractice Claims
- Suspensions and Revocations
- Practice License and Main Source Verification
- Unique Identifier (NPI)
- Previous Licenses
- DEA Certification
- Job Experience
- Diplomas and Transcripts
- Prior Employer/Practitioner References
- Information on Insurance
- Board of Examiners Certification
Criteria for Credentialing
Submission of a complete application and any necessary additions, which must not contain any intentional misstatements
The date of certificate attestation must be confirmed within 180 calendar days of the date of submission to the CC for a vote
There is no ongoing license activity in any state; and there is no history of licensing committee action in any state
Confirmation of primary references within reasonable times
There is no indication of any potential major omission(s) on the form
Re-credentialing
The re-credentialing process includes re-verification and the Identification of differences in the practitioners or HDO’s
- Licensure
- Certification
- Health status
- The performance data (including, but not limited to, negligence
Experience, hospital right or other actions) that may indicate on the Practitioner’s or HDO’s professional conduct and support All applicable practitioners and HDOs in the network within the range of Anthem Credentialing Program is expected to be credentialed every three years unless asked by agreement or state laws.
Phone number for Anthem Credentialing
Application for Anthem Enrollment
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FAQ! NEED HELP?
Anthem provider credentialing is the process by which Anthem verifies the qualifications
and experience of healthcare providers who want to participate in their networks. This
process helps to ensure that Anthem members have access to high-quality care from
qualified providers in the USA.
Anthem provider credentialing is important because it helps to protect Anthem members
from receiving care from unqualified healthcare professionals. It also helps to ensure
that Anthem is paying healthcare professionals fairly for the services they provide to their
patients or anthem members in the USA.
Any healthcare provider who wants to participate in an Anthem network needs to be
credentialed. This includes physicians, dentists, nurses practitioners, and other
healthcare professionals in all those states of the country where Anthem provide its
services.
We have an expert Anthem credentialing team; our medical credentialing expert
complete the Anthem credentialing process from start to final complete enrollment. The
main steps in the Anthem credentialing process are:
1. Stars Pro credentialing experts completes an application and submits it to
Anthem.
2. Anthem team verifies the provider's education, training, and experience
submitted by our team.
3. Anthem team checks the provider's licensure and malpractice history.
4. It is not compulsory but some time Anthem may also conduct a site visit to the
provider's office.
5. Once the credentialing process is completed, Anthem will notify Stars Pro about
provider credentialing status.
We have an expert Anthem credentialing team and our team will complete the whole
credentialing process, while the Anthem typically takes 60-90 days to complete the
enrollment process. However, it may take longer if Anthem has any questions or
concerns about the provider's application for the enrollment process.
1. Access to a large network of Anthem members.
2. Competitive reimbursement rates.
3. A streamlined credentialing process.
4. Support from a team of experienced credentialing specialists.
To apply to be credentialed by Anthem, you can fill the form on our website, our
credentialing experts will call you within 24 hours. You can also call our Anthem
Provider Credentialing team at 1-732-523-4633 for more information.
The process of maintaining your Anthem credentialing is simple, you must:
1. Keep your license and malpractice insurance up to date, if you have question you
can call stars Pro credentialing team any time at 1-732-523-4633.
2. Report any changes to your healthcare practice, such as a new address or
phone number.
3. Complete any required continuing education and inform to our team.
4. Cooperate with Anthem credentialing audits to avoid future problems.
If you have any questions about the Anthem provider credentialing process, you
can contact Stars Pro Anthem Provider Credentialing team at 1-732-523-4633.
Some common mistakes that providers make when applying for Anthem
credentialing by own include:
1. Healthcare professionals are submitting the application without completing the
application accurately and completely.
2. Providers are not submitting all of the required documentation on time.
3. Providers are not responding to Anthem's requests for information promptly.
4. Providers are not updating their contact information with Anthem.
Channel Partners
Stars Pro® Medical Billing inventive model is one of the fastest growing physician practice communities in the United States. We are dedicated to lashing change in the medical community by providing progressive, state-of-the-art solutions. Through our Channel Partnerships.
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