You will get Full Credentialing and RCM: Maximize Reimbursement for your Practice
Top Rated
Top Rated
Project details
Medical Billing & RCM Services:
Medical Billing & Coding
Verification of Benefits (VOBs)
Claims Submission & Rejection Resolution
A/R Follow-Up & Unpaid Claims Recovery
Denial Management & Appeals
Aging Reports Analysis
Prior & Retro Authorizations
🔹 Credentialing Services:
New Practice Setup / Enrollment / EIN Linkage
CAQH, NPPES/NPI Profile Creation & Maintenance
Credentialing, Contracting & Payer Enrollment
Demographic Updates & Address Changes
ERA, EDI & EFT Enrollment
🔹 Software & Portal Expertise:
✅ Simple Practice | AdvancedMD | Kareo / Tebra | TherapyNotes/ECW/Rapid PM/Trizetto
✅Prompt EMR | Unified Practice | NextGen Office | Office Ally | Headway/ Practice Fusion, ClaimMD/
✅ Insurance Portals: Availity, Optum/Provider Express, Cigna, BCBS, Medi, Medi-Routes, Bambi, Passport, Payspan, Echo, Zellis and more
🔹 Provider Specialties I am familiar with:
Mental Health & Substance Abuse
Psychological & Neuropsych Testing
Physical, Occupational & Speech Therapy
Chiropractic & Acupuncture
Surgical Services & Home Health
DME & Dental/Sleep Apnea treatment
Non-Emergency Medical Transportation (NEMT)
Allergy Testing and Immunotherapy
Housing Coordinators
Medical Billing & Coding
Verification of Benefits (VOBs)
Claims Submission & Rejection Resolution
A/R Follow-Up & Unpaid Claims Recovery
Denial Management & Appeals
Aging Reports Analysis
Prior & Retro Authorizations
🔹 Credentialing Services:
New Practice Setup / Enrollment / EIN Linkage
CAQH, NPPES/NPI Profile Creation & Maintenance
Credentialing, Contracting & Payer Enrollment
Demographic Updates & Address Changes
ERA, EDI & EFT Enrollment
🔹 Software & Portal Expertise:
✅ Simple Practice | AdvancedMD | Kareo / Tebra | TherapyNotes/ECW/Rapid PM/Trizetto
✅Prompt EMR | Unified Practice | NextGen Office | Office Ally | Headway/ Practice Fusion, ClaimMD/
✅ Insurance Portals: Availity, Optum/Provider Express, Cigna, BCBS, Medi, Medi-Routes, Bambi, Passport, Payspan, Echo, Zellis and more
🔹 Provider Specialties I am familiar with:
Mental Health & Substance Abuse
Psychological & Neuropsych Testing
Physical, Occupational & Speech Therapy
Chiropractic & Acupuncture
Surgical Services & Home Health
DME & Dental/Sleep Apnea treatment
Non-Emergency Medical Transportation (NEMT)
Allergy Testing and Immunotherapy
Housing Coordinators
Purpose
BusinessIndustry
Medical & PharmaceuticalLanguage
EnglishWhat's included
| Service Tiers |
Starter
$200
|
Standard
$500
|
Advanced
$1,000
|
|---|---|---|---|
| Delivery Time | 8 days | 12 days | 20 days |
Scriptwriting | - | - | - |
Summary Report | - | - | - |
Social Media Replies | - | - | - |
Email Support | - | - | |
Live Chat Support | - | - | - |
7 reviews
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SM
Samantha M.
May 2, 2026
Medical Biller for CentralReach Essentials Setup
NF
Nickolas F.
Apr 3, 2026
Credentialing and Account Setup for Insurances
Very responsive and knows exactly what he is doing. Highly recommended
AB
Amber B.
Nov 3, 2025
Credentialing Specialist needed for mental health practice
Doustan truly understands credentialing and works as quickly as possible to get your staff credentialed.
SS
Sara S.
Oct 21, 2025
Experienced Insurance Credentialer - Adding Providers to Existing Group Contracts Only
It has been such a pleasure working with Doustan! He is an excellent credentialer who knows the ins and outs of each insurance panel, making the entire process go very smoothly. I don't know what our practice would have done without his hard work and dedication! We definitely hope to work with Doustan again as our practice continues to grow. Highly recommend!
AC
Anabel C.
Sep 19, 2025
Credentialing for an MD into Medicare
Fast, reliable and great communication!
About Doustan
Medical Biller & Credentialing Specialist | All Specialties Expert
100%
Job Success
Rawalpindi, Pakistan - 2:03 am local time
I specialize in credentialing providers with Medicare, Medicaid, and commercial payers, managing group and solo enrollments, NPI and CAQH setup, PECOS registration, and insurance contract negotiations. In billing, I am proficient in ICD-10, CPT, HCPCS coding, insurance policy navigation, and claim appeals ensuring timely reimbursements and reduced denials.
Comprehensive Core Credentialing Competencies:
1. Managed credentialing and re-credentialing for solo providers, groups, clinics, hospitals, and home healthcare agencies.
2. Skilled in adding providers to existing contracts, new enrollments, and complex re-credentialing processes.
3. Expert in Medicare PECOS enrollment, Medicaid state portals, CAQH registration, and commercial payer enrollment.
4. Thorough knowledge of HIPAA, PHI, and federal/state healthcare credentialing regulations.
5. Conducted primary source verification for licensure, education, certifications, and professional background.
6. Managed full NPI lifecycle including creation, updates, and maintenance for billing accuracy.
7. Assisted in reviewing and negotiating managed care contracts to secure favorable reimbursement terms.
8. Maintained and updated CAQH profiles, PECOS, and multiple insurance payer portals.
9. Performed compliance audits and maintained credentialing files to prevent claim denials and ensure regulatory adherence.
10. LLC Formation.
11. Business Registration.
12. EIN/TIN and NPI Creation
Medical Billing & Claims Processing
Full-service billing: submission, follow-up, and posting
ICD-10, CPT, and HCPCS coding for mental health, therapy, and medical specialties
Denial management and appeals
Claims tracking, reconciliation, and reporting
EDI, EFT, ERA setup with insurance portals
Insurance verification and pre-authorization
Expertise in Medicare, Medicaid, BCBS, Aetna, Cigna, UHC, and other payers
Out-of-network billing support and reimbursement recovery
Revenue Cycle Management (RCM)
AR follow-up, patient invoicing, and balance collection
KPI tracking: Days in A/R, denial rates, collection rates
Cash flow monitoring & financial performance reporting
Monthly/annual AR reporting with tailored analytics
Compliance & Quality Control:
HIPAA and PHI confidentiality adherence
Accurate documentation and audit preparation
Credentialing file audits and compliance monitoring
Regulatory knowledge across multiple states
Specialty Knowledge Areas:
Mental Health: Therapy, counseling, medication management, psychiatric services
ABA/BCBA: Credentialing with Medicaid, commercial plans, and MCOs
Therapy Services: PT, OT, ST including pediatric and adult therapy billing
Ophthalmology & Retina: Mohs surgery, injections, imaging, and surgical claims
Dermatology: Biopsies, cosmetic vs medical differentiation, multiple procedure billing
Home Health & DME: HCPCS coding, supply chain coordination, eligibility verification
Software Proficiency
Billing Platforms: ECW, AdvancedMD, Kareo, Office Ally, Therabill, WebPT, CareCloud, RXNT
Therapy & EHR Systems: Simple Practice, TherapyNotes, Central Reach, DrChrono, TheraNest, NextGen
Insurance Portals: Availity, Navinet, Medicare/Medicaid state portals, CAQH
Practice Management Tools: Tebra, eClinicalWorks, Claim.MD, and others
Why Choose Me?
1. Specialized Experience: Deep understanding of credentialing and billing within niche sectors like ABA, therapy, and retina care.
2. Problem Solver: Skilled in identifying the root causes of claim denials and implementing corrective measures.
3. Compliance-Focused: I ensure complete adherence to all payer rules, HIPAA regulations, and industry standards.
4. Proactive Communication: Frequent updates, transparent reporting, and prompt responses.
5. Remote Team Leadership: Experience managing offshore billing teams and credentialing staff with consistent productivity.
What I Offer:
Credentialing for group and individual providers
Medical billing and collections management
Denial resolution and appeals handling
Insurance contract support and negotiation
Full-cycle revenue management and consulting
Custom reporting and performance analysis
EDI/EFT/ERA setup and troubleshooting
One-on-one support for private practices and agencies
Availability
Remote/virtual work capability
Flexible hours across U.S. time zones
Immediate availability for short or long-term projects
Steps for completing your project
After purchasing the project, send requirements so Doustan can start the project.
Delivery time starts when Doustan receives requirements from you.
Doustan works on your project following the steps below.
Revisions may occur after the delivery date.
Practice & System Review
Review practice details, providers, payers, billing software, and current workflow to understand requirements and identify gaps.
Eligibility & Charge Review
Verify patient eligibility, benefits, and review charges, CPT/ICD codes, and documentation for billing accuracy.