Provider Credentialing

Credentialing Services

Provider credentialing and provider enrollment services is a process of enrolment and attestation that a physician is part of a Payer’s network and authorized to provide services to patients who are members in the Payer’s plans. Credentialing verifies that a physician meets standards as determined by the Payer by reviewing such items as the individual’s license, experience, certification, education, training, affiliations, malpractice & adverse clinical occurrences and clinical judgment.

Need for Provider credentialing services

Effective provider credentialing services are the absolute necessity for better performance of the practice. Without proper enrolment, payments can be delayed or refused by the insurance carriers, even if the physician is able to provide services that are competent and medically necessary.

Lister's Credentialing services include

Provider Enrollment Services

  • New-Hire Provider Enrollment
  • Provider Document Maintenance<
  • Medical Credentialing/Re-Credentialing
  • NPI/CAQH Registration/Monitoring
  • Hospital Privileges (Appointment/Re-Appointment)
  • Medicare/Medicaid (Initial/Re-Validation)

Who We Help

  • Physicians
  • Nurse Practitioners
  • Physician Assistants
  • Urgent Care Facilities
  • Audiologists
  • Behavioral Health Providers
  • Physical, Occupational & Speech Therapists
  • Labs, ASCs & Imaging Facilities
  • FQHCs & Rural Health Clinics
  • Hospitals & Universities

States we operate

  • We work throughout the United States of America
  • Our Head office is located in California

Require verification

  • Medical License: State Medical Board/Dept of Health and/or Federation of State Medical Boards (FSMB). 
  • Board Certification: American Board of Medical Specialties (ABMS), American Osteopathic Association (AOA) 
  • DEA/Controlled Substance. 
  • Malpractice: National Practitioner Data Bank (NPDB) 
  • Disciplinary Actions: NPDB, State Medical Boards 
  • Sanctions: OIG, Medicare/Medicaid 
  • NPI – National Plan Provider Enumeration System (NPPES) 
  • Work History 
  • Facility Privileges 
  • Peer References 

Insurance carrier we work with

  • We can work with any insurance carrier, including not limited to;
  • Aetna
  • AvMed
  • Blue Shield
  • Blue Cross
  • DeltaCare
  • Cigna
  • Humana
  • Medicare HMOs
  • Principal
  • Amerigroup
  • Champus
  • Great West
  • Medicaid HMOs
  • TriCare
  • Guardian
  • MetLife
  • United Healthcare
  • BCBS
  • Coventry
  • Medicare
  • Molina
  • Universal
  • Medicaid
  • Multiplan
  • WellCare