SERVICES

Services

Our Goal

To deliver a superior level of service that fosters obnoxiously devoted partners. We will meet your credentialing and enrollment requirements and exceed your expectations. 

Primary Source Verification

Consider the source.

Be confident in your decision to appoint staff members with the knowledge of knowing you have conducted a thorough investigation.  Credential America excels in developing and customizing a scope of service to meet your bylaws, state regulations and accreditation standards. Our industry knowledge of all accrediting bodies (TJC, NCQA, URAC, AAAHC, DNV, and/or CMS) allow us to service our national partnerships. 


Primary source verification (PSV) is defined as verification from the original source of a specific credential (education, training, licensure) to determine the validity of information provided by the practitioner. Hospitals and health plans conduct PSV in the credentialing process to verify and validate that a healthcare provider is qualified and competent to provide patient care.

Payer Enrollment

Enrollment influences the Bottom Line. 

Reduce the administrative task and maximize your revenue flow by delegating your provider enrollment function to Credential America. Whether you are a solo provider or group practice, everyday counts when it comes to health plan enrollment. Trust the team at Credential America to efficiently and effectively enroll your practitioners.


Payer enrollment is defined as the act or process in aiding a provider to be enrolled with a managed care organization.

Practitioner Tracking and Maintenance

Keeping your finger on the pulse.

Don’t let another day go by without keeping your finger on the pulse of credentialing elements with an expiration date. Current and up-to-date credentials are vital to remain compliant. Licenses, DEAs, professional liability insurance, CAQH profiles, re-credentialing dates….the list goes on. Allow Credential America to manage these critically important elements.

Consultation

Lean on our strengths.

With over three decades of knowledge, experience, certified staff, and a diverse partner portfolio, we are here to help you when it comes to efficiently and effectively managing your organization and operations. We can assist with process improvement, bylaws creation, delegated contracts, amongst other objectives.

Special Projects

Lighten your load.

Delegating a special task due to limited time and internal resources may benefit you on a case-by-case basis. If it’s credentialing locum tenens, NPDB PDS enrollments, professional review of applications, auditing, or any other function that requires temporary relief to help manage operational stressors, let us lend a hand.

Criminal Background Checks

  • Social Security Number Trace

    Social Security Number Trace is the crucial first step in a thorough background check. It finds any aliases, confirms the validity of the Social Security Number, and finds other important data points.


    Using the SSN trace will also identify all residences. This is important because statistics show that crimes often occur close to where people live and work. 

  • County Criminal Background Checks

    County Criminal Records Searches are the gold standard for any background check. In-person searches at courthouses are done in all US jurisdictions and territories.  The in-person criminal background checks use name and date of birth to search for offenses across the country. 

  • State Criminal Record Searches

    Felony and misdemeanor searches of state criminal records are conducted at each applicable state central repository.  Many states maintain a central criminal history record repository. This is where they collect case information from law enforcement agencies and courts throughout the state. 


    Note: Not all statewide searches are equal. Some states don't provide access to a repository. And many only store limited information from reporting counties. 

  • Federal Criminal Records Search

    Federal Criminal offenses are crimes committed against the US government. Thus, they will not appear on searches on the state and county level.  Some of the offenses that fall under federal jurisdiction include: embezzlement, bank robbery, and interstate drug trafficking.  Searches of criminal filings are done in any of the nation’s 300 Federal District Courts. 

  • National Criminal Research Search

    We recommend this search as a tool in several instances. First, for uncovering criminal offenses that occurred outside of the areas where the applicant has lived. And second, to find criminal activity not identified by the social security number trace based on your search criteria.

    The National Criminal Research Database Search (NCRD) instantly searches almost one billion offense records across 50 states and multiple jurisdictions. The database is compiled of criminal records and information from municipal, circuit, district and superior court repositories. It also includes the Department of Corrections, the FBI, US Marshal, US Customs, the DEA, the Secret Service, and the Department of Justice.

    Also included in the NCRD search is 50-state sex offender registry information, healthcare sanctions, financial sanctions, terrorist watch lists, and OFAC (Office of Foreign Asset Control). All records found from this search are automatically confirmed from the actual source.


  • International Screening

    Record Searches in over 210 countries.

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