Our EHR/RCM solution tailored for psychiatric and counseling services offers comprehensive support for practitioners in managing patient records and revenue cycles efficiently. Seamlessly integrated with specialized features, our platform caters to the unique needs of mental health professionals, ensuring streamlined operations and enhanced patient care delivery.
Behavioral Healthcare Technology
DENmaar Guardian EHR/RCM Revolution
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Time Tracking
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Claim Support
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More Revenue
EHR/RCM
For Psychiatric and Counseling Services
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Improves patient care
outcomes by providing better decisions, care coordination, and patient engagement
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Reduces medication errors
by checking for interactions and automating refills
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Enhances patient-provider communication
by supporting telepsychiatry and secure messaging
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Simplifies medication management
with proper data accessibility
Streamlines clinical workflows
by offering intuitive dashboards, note templates, digital scheduling, and billing features
Increases revenue and reduces costs
by optimizing coding, claims, and collections processes
Ensures compliance and security
by following HIPAA, HITECH, and other regulations
The DENmaar service teams supports insurance credentialing and
the insurance claims process, ensuring maximum cash flow and revenue.
Professional
Insurance Services
Insurance Credentialing
Services
DENmaars insurance services are for group practices, where adding providers’ to insurance panels and maximum insurance revenue is a priority.
- Provider Enrollment and Credentialing services
- CAQH Registration and Enrollment
- Individual and Group Medicare Enrollment
- Insurance Contract Negotiations
- Payer Fee Schedule Creation and Evaluation
- Telemedicine Credentialing
Behavioral
Health Billing
We offer top-tier behavioral health billing services powered by our robust software and expert consultants.
- Professional Billing
- 24 Hour Claims Submission
- Claim Status provided in Real-Time
- Immediate Eligibility Verification
- Rejection and Denial Resolution
- U.S based Claims Specialist Assigned
- Credentialing Specialist Assigned to Account
What Our Clients Say
Thank you for your diligence!! I appreciate it so much. Thank you Edwina…
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Thank you so much Amy! I will be referring to DENmaar as often as I am asked about credentialing services.
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Thank you so so much Donna. You have helped make our company so much stronger. We appreciate you.
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Working with the Denmaar platform and Amy has been a pleasure, thank you! It is a relief not to worry about the insurance portion of the private work.
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Edwina, Thanks for your help. I appreciate your patience with me.
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Victoria you have made my life so much easier. Thank you for the outstanding work. You are so helpful.
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Thank you Donna for jumping in and helping us out so much. You have no idea how much I appreciate it!
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“I absolutely love all the features for intake/evaluation/assessment/progress notes!”
Thanks so much for all your help over the years, we COULD NOT have built our behavioral health division without your keen expertise and steadfast work ethic!
Thanks so much for your help in getting me set up with DENmaar. I am looking forward to working with your company as you all seem so much more personal than other places I have checked out. Hope you all never lose that. Wishing you blessings in your life!
Working with the DENmaar team showed great professionalism beyond anything I would ever expect! Prompt on returning emails. Whenever I had a question, it was almost returned within the hour. Living overseas I would send emails not expecting a response until the next workday but there were times that in the middle of the night, I would get back fully answered emails to any questions I had. My wife and I are confident that if the rest of DENmaar is half as good as the onboarding is this will be a great experience for us. Thank you for everything.
Thank you, I appreciate all that the team does.
love working with Denmaar. You guys are always on it. You Do not find that at most places. Thanks again,
Wonderful and thank you so much. I do not know what I would do without you and your team.
Thank you so much for your time and your amazing help! It is appreciated! Thank you
I really appreciate you getting back to me so quickly and explaining so simply what is going on. Makes complete sense! Thank you again for working so hard! You are awesome.
Thank you for helping me through my problems with getting the right documents to you. I am so glad we went with your company as everyone has been so nice to work with.
Hey Victoria, Thanks for all your help thus far. You have been very helpful, fast, and so thorough! you get an A+ from me
“Victoria, you have been amazing throughout this entire process. You are always pleasant, and you always reply so quickly. I appreciate you so much!”
“Thanks so much for helping along this process and following up with me. I truly appreciate it.”
“Yea!!!! You are awesome. Thank you so much.”
“Thank you for your help! I greatly appreciate it.”
I appreciate your hard work!”
“You are wonderful, thank you so much for all your patience and help with this!
“Thank you for the extra support. It has made me much more comfortable and taken away considerable stress.”
Victoria
“I can’t thank you enough. You really are the best. I don’t know what I would do without DENmaar “
“Thank you so much! Erika, I appreciate you so much. I will cease to be concerned.”
“Great working and getting to know Donna! She’s a power house and knows her stuff.”
Victoria
I really appreciate all the legwork that you are doing for me in getting me on these panels. It’s really greatly appreciated and I want to thank you for all your efforts on my behalf. Warmest Regards,
“Donna, Erika and Nicole are always so kind and helpful”
“Donna helped me tremendously when I started!”
“Working with Victoria and Erika has been great. So happy with your services.”
“Thank you Lindsay for your patience.”
Melissa Wutrick
“I appreciate the good work and helpfulness.”
“Thank you so much.
I seriously dont know what i would do without you guys!!”
“Thank you Edwina for helping me with this situation.”
“So grateful for all of your help Chandra, Sorry this was such a complicated one.”
“Thanks DENmaar, you have been amazing. And thank you for being so understanding. I will definitely be referring people over to you for billing.“
“Chris and his world class DENmaar team have done the billing and credentialing for my practice for 10+ years. There are not enough of superlative adjectives to describe how pleased I am with the services they have provided. The persistent and tenacious approach to billing has yielded the most lucrative cash inflow that I have ever experienced in my 30+ years of private practice. Chris and his group help with keeping up credentialing in superb fashion. I have referred many fellow professionals to use DENmaar and all are equally awed. I would recommend them with the highest possible accolades.”
“Amy is awesome! “
“Nicole you’re the best!”
“Thank you Amy. I truly appreciate all you do!”
“Huge shout out to Victoria and Ashely for putting up with me and helping our practice continue to grow. Fourteen short months ago we founded BN Wellness Group, and we now are getting recognition as a force in the greater Cleveland area. “
“DENmaar you are a wealth of knowledge and I greatly appreciate your time and help. “
Thank you!
Donna your capabilities to get us paneled are wonderful.
You have been just fantastic….
Thank you so much DENmaar! Thank you for ALL that you do to make our company run smoothly; we appreciate YOU.
You are a real pleasure to work with Victoria. I know I’ve asked you to do a lot of hand holding as a new group practice owner.
And you should know that I recognize the extra effort and really appreciate the way you’ve supported me through this process. Thank you again for the professional service and courtesies you’ve extended. Definitely worth the expense.
Thank you Donna for your GREAT assistance!!! You are awesome to work with.
whohooooool Amy is great give her chocolate cakel
Thank you!
Thank you so much Donna. It is really helpful, and exactly what we were looking for.
Thank You for your fast response.
Thank you so much Donna for help over this past week, you have been awesome!! We all really appreciate it.
Donna. You are so awesome and we appreciate your hard work.
I just wanted to thank you Donna for diligently following up with
BCBS and keeping me in the loop!
Edwina is a true hero in my book. She was incredibly persistent, professional & patient thru the whole grueling process with Optum. Could not have done it without her. I am SO grateful for her awesome efforts. Thank for all you and the team does for us.
YOU are a SAINT Edwina!
Thank you!!!
Hello Chris,
The credentialing process with GA Medicaid took long but all through the process Denmaar employees were always responsive and ready to help. I was assigned to Nicole first and Amy later. They both were patient and kept following up with Medicaid and updating me till I finally got approved. I’m happy with my experience
Victoria you are awesome! TY!!!
I can’t express my gratitude for you Donna,
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Capterra, Software Advice And Get App 2023 Best Of Badges Awarded To DENmaar
2023 “Best of” badge winners = DENmaar Guardian has earned a well-deserved Best Value Badge.
See our reviews for our software being recognized as an impactful solution for your business.
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Our Latest Blogs
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Expansion Of Telehealth To Make It Part Of The Permanent Workflow By CIOs
Over the past two years, hospitals and health systems have quickly deployed several telemedicine systems to look after patients during the ongoing Covid-19 pandemic. But unfortunately, many of these systems were not planned in great detail or designed with a view to sustainability.
Nonetheless, telehealth has taken root, and now healthcare providers face the future with mixed care: personal care and virtual care. As a result, providers are starting to think more about their applications of telemedicine technology.
CIOs and other health IT leaders are thinking about implementing health systems across hospitals and enabling doctors to use technology in their current workflow. Moreover, many officials are considering expanding the scope of technology in the hospital to include all departments.
Hospital’s technological needs have changed rapidly during pandemics, and many patient-facing systems are rapidly operating to meet the demand for video visits.
Hospitals seek permanent designs that are part of their workflow.
In the last few months, what happened across the country has been shocking and has led to telehealth’s emergence from most healthcare systems’ basements. The concept that was once considered a “pleasure” at the use-case level quickly became a “necessity” at the enterprise level throughout the patient’s journey.
Many realize that successful, integrated telehealth solutions are more than just doctors on-screen. Instead, when deployed comprehensively, they act as a digital front door to the health system, delivering clinical experiences and ultimately improving patient commitment.
Integrated care for the individual has been proven to prevent and reduce health risks, and you can use virtual care technology to improve care outside of a hospital setting.
Telehealth is no longer a separate component or competitive advantage for hospitals and health systems – it is a requirement and will provide financial benefits, improved reputation, and care.
Embedding system-wide telehealth technology as part of their ongoing workflow
Streamlining technical and administrative processes related to providing virtual care through modern and unified platforms will simplify the workflow and improve the care experience.
Combining technology and administrative processes reduces the administrative burden on platform users and increases communication and collaboration in the team.
A single platform promotes fewer login, screen, and apps and extended capabilities such as viewing appointments, accessing current patient information, and combining chat and video appointments with colleagues.
It is imperative to access the curated data presented as actionable insights on the same platform- This enables better personal care throughout the patient’s most needed journey.
Virtual access to patient’s room
How can CIOs and their team take advantage of this technology and expand it within the four walls of a hospital? For instance, in every department, or even on every TV screen in every patient’s room.
Equipping each patient’s room with telehealth capabilities and virtual access gives carers instant access to patients for various cases.
Virtual nursing units are an example of this idea. About two-thirds of nursing tasks, such as drug testing and some paperwork, are activities that do not need to be touched, and the caregiver does not need to be physically at the bedside.
By enabling each patient room in a virtual nursing unit with telehealth equipment, bedside nurses can focus on providing high-quality patient care by carrying the burden of non-functional care and administrative tasks. We have seen virtual nursing units that can discharge patients about 20% more than conventional nursing units within two hours of receiving a discharge order.
Furthermore, some of these units discharge patients 44% more in the afternoon than their traditional nursing counterparts. These metrics help increase productivity in opening rooms early to accommodate more patients and improve patient satisfaction.
It is also vital to note that patients often interact with people other than doctors and hospital caregivers. Virtual in-room care, often via a hospital room TV or another in-room device, can enable social workers or family members to communicate safely and efficiently with the patient while in the hospital.
Where to get the best telehealth solution?
DENmaar’s telehealth solution provides a quick and secure way to start a telemedicine session with the ease of a phone call. Whether starting with an electronic medical records system or a provider application, a click of a button prompts a patient to start a session.
DENmaar’s TeleHealth system is HIPAA compliant, providing a safe way for patients to quickly and safely provide treatment or prescribed services.
Telehealth, telemedicine, and telenursing are changing the world of healthcare forever as we know it. DENmaar is part of that change, and so can you. Call us today!
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5 Credentialing Issues in Healthcare & Their Resolutions
Credentialing issues in healthcare are extremely common. In fact, the process of provider credentialing has to be a prominent compliance issue for medical practices. It is quite normal for providers to have their applications rejected due to omissions and errors. The consequences can be considerably more disastrous without proper data insight and process oversight.
Table of Contents
- 1. 5 Common Credentialing Issues
- 2. Overcoming Issues with Healthcare Credentialing
- 3. We recommend verifying your state’s guidelines for:
- 4. The Bottom Line
Now, mistakes happen in any process. However, the mistakes in credentialing can be especially punishing. For instance, credentialing issues for nurse practitioners can cost a nurse their career. Moreover, mistakes in credentialing can cost healthcare organizations their hard-earned reputation. Suffice to say, no one can afford the legal and financial complications that follow a poorly executed credentialing process.
In this article, we would like to shine a light on some of the most common challenges with the medical credentialing system. We hope that being aware of these challenges will make you better equipped to tackle them.
5 Common Credentialing Issues
1. Keeping Information Up-To-Date
Many healthcare organizations struggle to access relevant applicant information. It is estimated that around 85% of submitted applications suffer from inaccurate, missing, or irrelevant information. It is mandatory to re-attest even minor changes like changes to address and phone number in the CAQH database.
Missing information or outdated details can quickly derail the already complicated and time-consuming credentialing process. The issue becomes even direr when you consider how frequently individual practitioners change the healthcare institutions they work for. Healthcare organizations must keep pace with the changes as they occur to avoid issues during the process.
2. Time-Consuming
It is no secret that the medical credentialing process is a time-consuming one. An application review can take around 90 days to complete. When you consider the involvement of additional stakeholders like contract negotiators and insurance companies, the process can easily go as long as six months. That is a long time and most healthcare organizations find their operations stalled because of it.
3. Staying Compliant
As we mentioned before, compliance issues are most prevalent in the credentialing process. Each state has different standards and policy guidelines that a provider needs to adhere to. Additionally, national organizations like CAQH have their own specific requirements that have to be met as well. This, of course, causes frustrating issues.
Read More: Credentialing Process Checklist You’ll Need in 2022
The rules, regulations, and requirements for medical credentialing vary from state to state. It also doesn’t help that these rules and regulations are volatile and experience frequent changes. It is important to leverage a reliable credentialing service or system to keep up with varying and changing regulations.
4. Challenging to Change Credentialing Program
As your healthcare organization grows and credentialing requirements become inevitably more complex, you will have no choice but to add integrations or switch to a different assessment system entirely. Migrating information in such a scenario, especially when you have a lot of preset prompts and questions that are not standard compliant, can become almost impossible.
You will have no option but to lose one or two components to make the migration possible. It is precisely because of this reason that many healthcare organizations get stuck with outdated platforms that are not capable of efficiently undertaking the credentialing process.
5. Ensuring the Privacy of Healthcare Professionals
Background checks are an integral part of the credentialing process. They are essential to determine that the applicant possesses the skills and qualifications required to provide care to patients. The process entails the submission of crucial documents such as practice license, work history, education qualification, etc.
As such, privacy become of the utmost importance. The credentialing organization will require information about an applicant’s entire history. Not disclosing this important information can result in the practitioner’s application being rejected. You will need a credentialing service or platform that keeps all of this information up-to-date and secure from prying eyes. Sadly, most organizations don’t have adequate platforms to safeguard such valuable information.
Overcoming Issues with Healthcare Credentialing
1. Outsource Your Credentialing Task
When it comes to hiring someone to overtake your credentialing process, there are two options at your disposal. You can try hiring an in-house staff that is dedicated to managing the process from start to finish or opt to outsource the task to third-party specialists like DENmaar.
Out of the two, outsourcing is evidently a relatively more cost-effective and time-efficient way to handle credentialing. With outsourcing, you get access to credentialing experts and their technology. Moreover, you aren’t saving money by not hiring personnel on salaries.
2. Pay Special Attention to Individual State Guidelines
It is important to do your homework with regards to what rules, legislations and policies would be applicable to your healthcare organization. As each state has different requirements, you need help of medical credentialing experts that are aware of policies and can help you with seamless and compliant transition.
We recommend verifying your state’s guidelines for:
- • Licenses
- • Education qualifications
- • Certifications.
3. Leverage Credentialing System Technology that Automates the Process
There are systems and advanced technology available today that can help your business automate the credentialing process to a good degree. We recommend looking for a credentialing platform that can:
- • Reduce Credentialing Workload Affecting Your Staff
- • Reduce Training Time for New Staff
- • Save time to focus on company growth.
Implementing such technology can be expensive. However, you stand to enjoy greater benefits in the long run with these technologies managing crucial aspects of your credentialing process.
The Bottom Line
Credentialing is no child’s play. Most healthcare organizations do not have the staff or resources to handle it with the care deserved. Fortunately, you can save yourself a lot of trouble by simply hiring credentialing specialists like DENmaar.
We understand how frustrating the process can be, and thus offer services dedicated to relieving you of this unwanted burden. We provide a fully automated system that gives you real-time updates of your credentialing application status. Plus, you get automatically notified by our robust system on the imminent expiration of documents, so your practice continues to legally serve patients with insurance. Moreover, we offer medical insurance credentialing services for sole practitioners as well as huge medical organizations.
![featured_image](https://denmaar.com/wp-content/uploads/2022/04/What-is-Medical-Credentialing-and-How-it-Works-Costs.png)
What is Medical Credentialing, and How it Works & Costs?
Medical credentialing is a complex concept to understand. So it is only natural for one to have several questions about it. In this article, we aim to answer some of the most frequently asked questions surrounding the topic, and in the process, help you understand this complicated but fundamental aspect of our medical world even better.
Table of Contents
- 1. How Exactly Does Medical Credentialing Work?
- 1.1. What are the Benefits of Medical Credentialing?
- 1.2. Can a Provider Allowed to Work During the Credentialing Process?
- 1.3. What Kind of Facilities Need Credentialing?
- 1.4. What is the NCQA?
- 1.5. What is TJC?
- 1.6. What is CMS?
- 1.7. What Does Primary Source Verification Mean?
- 1.8. What is the Credentialing Committee?
- 1.9. How Long Does a Medical Credentialing Process Last?
- 1.10. How much will Medical Credentialing Cost You?
- 2. What Do I Look for in a Credentialing Service Provider?
So without much further ado, let’s get started.
How Exactly Does Medical Credentialing Work?
Medical credentialing is a process undertaken with the main purpose of maintaining high standards of quality expected from the medical industry. The process usually entails the verification of a healthcare provider’s competency with regards to their educational qualifications, work history, certifications, etc.
A credentialing authority will contact a provider’s university, certification board and licensing agency to verify whether he or she is capable of providing healthcare. Credentialing is considered to be imperative for all types of providers who engage in providing medical assistance to patients. It needs to be conducted at regular intervals to make sure a healthcare organization or provider is complying with regulatory standards and policies set by bodies like the Centers of Medicare and Medicaid Services, The Joint Commission, National Committee for Quality Assurance, etc.
What are the Benefits of Medical Credentialing?
Medical credentialing has a plethora of benefits in store for all parties involved with the process. Credentialing provides hospital and clinics with the assurance that their hired staff will offer their services at the level of standards expected of them. Insurance companies can keep their costs down by making sure only competent medical professionals pass the credentialing process.
Practitioners also benefits immensely from credentialing as they can expand their services to more patients with access to different types of health insurance. However, patients stand to benefit the most out of credentialing. They can rest assured on receiving the highest quality of care from the most qualified providers.
Can a Provider Allowed to Work During the Credentialing Process?
It is recommended for a healthcare provider to halt their services until the entire credentialing process is complete. This guarantees that all patients receive quality care from only those providers who have verified qualification to offer their services. A healthcare organization is putting itself in unnecessary risk by letting non-credentialed individuals work for them.
That being said, there are a few exceptions to the rule. Medical students, for instance, don’t need credentialing as long as their duties to do not cross the scope of their educational program. They typically don’t need to undergo credentialing as they are working under the strict supervision of superior credentialed providers.
What Kind of Facilities Need Credentialing?
Aside from practitioners, facilities that engage in the act of providing healthcare need credentialing as well. As such, the following services and facilities need to undertake the process to show they comply with the expected standards of care and competence.
- • Dialysis
- • Ambulance
- • Home Health Services
- • Hospice Care
- • Durable Medical Equipment
- • Independent Diagnostic Testing
- • IV Home Infusion Therapy
- • Laboratories
- • Prosthetics
- • Orthotics
- • Lithotripsy
- • Urgent Care Centers
- • Radiology
What is the NCQA?
The NCQA, aka The National Commission for Quality Assurance is an independent non-profit organization. Their job is to evaluate the quality of healthcare provided by medical practices and issues credentials based on their findings. The organizations that go to NCQA for credentialing include managed behavioral healthcare organizations, preferred provider organizations, credentials verification organizations, etc.
What is TJC?
The TJC, or the Joint Commission, is an organization tasked with maintaining high standards of healthcare in the United States of America. They conduct surveys that aim to verify the standards of healthcare provided by the hospitals in USA. Organizations like hospitals proactively answer to accrediting surveys hosted by the TJC every three years.
What is CMS?
The CMS, or The Centers for Medicare and Medicaid Services is a federal agency that serves under the United Stated Department Health and Human Services. It is responsible for performing a number of functions, which include evaluating quality standards of clinical labs and facilities that have been offering care to patients for a long time. The CMS works closely with state governments to administer and monitor Children’s Health Insurance Program, Medicaid, etc.
What Does Primary Source Verification Mean?
Primary Source Verification basically means that a credentialing authority will directly verify a provider or organization’s credentials from the source of that credential itself. For instance, a CVO will directly contact the university to verify a practitioners education qualifications. This is usually done to avoid fraud. As such, documents from third-party sources are not entertained.
What is the Credentialing Committee?
Credentialing committee is responsible for overseeing the entire application review process. They have to make sure that the applicants meet the desired set of quality standards. This committee will include doctors with varying specialties, a liaison with the CVO and a chairperson. If you meet the basic requirements of credentialing, you can appeal a committee’s decision. You will receive all the information needed if it is deemed that you have the right to appeal.
How Long Does a Medical Credentialing Process Last?
The medical credentialing process can be excruciatingly long. It can take anywhere from days to weeks, and sometimes months. Typically, you can expect the credentialing process to take as long as 90 to 120 days. As such, we recommend starting your application process at least 3 months before you begin your duties as a healthcare provider.
How much will Medical Credentialing Cost You?
The costs for medical credentialing will vary from CVO to CVO, organization to organization and specialty to specialty. Generally speaking, you can expect to pay around three to four hundred dollars for your application fee alone. You can also anticipate partial reimbursements after your credentialing process has been completed successfully.
You will also incur costs on periodic and re-credentialing as well. However, you can expect to get this done at a discounted rate.
What Do I Look for in a Credentialing Service Provider?
Experience and a good reputation are arguably two of the most prominent factors you must consider when looking for a credentialing service provider. Such service providers are usually home to credentialing specialists who possess the resources, insight and experience needed to handle the entire credentialing and re-credentialing process from start to finish in a quick, efficient and hassle-free manner.
You will find the above qualities demonstrated perfectly by the credentialing specialists’ right here at DENmaar. With years of industry experience, we’ve helped many providers and facilities get credentialed and can do the same for you.
Reach out to us at 844-727-3627 to learn more about our services.
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- Tailored EHR/RCM solution for psychiatric and counseling services
- Comprehensive support for managing patient records and revenue cycles
- Specialized features seamlessly integrated
- Addresses unique needs of mental health professionals
- Streamlines operations and enhances patient care delivery