How it Works

Webster’s Dictionary defines “credentialing” as a verb, first known in 1888 and meaning, “to furnish with credentials, to credentials adequate academic performance.”

A doctor living in a metropolitan area may have privileges at four to five hospitals and participate in four to six HMOs and numerous PPO or other types of managed care health plans. This does not take into account the personal injury (auto plans), indemnity, or discount health cards, all vying for the provider’s attention and their credentials. On average, a medical provider is completing six to 10 applications each year, taking time, money and staff to complete.

CredNet is building the nation’s largest credentialed network, with its primary purpose being to facilitate the housing of providers including physicians, dentists, chiropractors, podiatrists, psychiatrists, nurses, social workers and other therapists to forge a collaborative relationship between providers and managed care.

The strategy is to implement a network that will allow providers to be credentialed in one place by one organization in such a way that all payers and non-payer PPOs would accept and contract to delegate the credentialing to CredNet. To do this, the company will create a network unlike any other.

It will not be limited by hospital, health plan or geography. It will contract to verify the physician's credentialing file from its partner Med Advantage, a nationwide Credentials Verification Organization (CVO) with the reputation and experience of performing this process very efficiently.

CredNet will then conduct its own peer review and assess a rating on the provider, opening the usage to all health insurance companies, health plans and hospitals. The physicians' fee agreement, if any, with the health plan will be completely separate from CredNet, while the provider still reaps the benefits of delegated credentialing.

The resulting structure allows subscribers to receive a long-sought solution to all of their credentialing woes and dramatically reduce a never-ending budget line item. They will have one credentialing source, one credentialing schedule and one application. Additionally, new providers can become paneled much faster and with less hassle. CredNet even provides its members with a website that allows providers and administrators to log in, submit their credentials and check the status of all pending credentialing.