End-to-end enrollment and contracting with insurance payers for faster reimbursements.
Provider credentialing is the foundation of your revenue cycle. Without proper enrollment with insurance networks, you cannot bill for services or receive reimbursements. Our credentialing specialists handle the entire process from initial application through final approval, ensuring accuracy and efficiency at every step.
What’s Included:
Initial Credentialing:
- Complete application preparation for all insurance networks
- Enrollment with Medicare, Medicaid, and commercial insurance payers
- Managed care organization (MCO) credentialing
- Hospital privileging support and coordination
- Group credentialing for multi-provider practices
CAQH Profile Management:
- Initial CAQH ProView profile setup and configuration
- Quarterly attestations to keep profiles current
- Document uploads and updates as requirements change
- Monitoring for expiring credentials and certifications
- Immediate response to CAQH deficiency notifications
Documentation & Verification:
- Collection of all required credentials (licenses, DEA, board certifications)
- Professional liability insurance verification
- Education and training verification
- Work history documentation and gap explanations
- Professional reference collection and follow-up
- Background check coordination
- OIG and SAM exclusion list screening
Payer Communication:
- Regular status checks with every insurance network (every 10-14 days)
- Response to requests for additional information
- Resolution of application deficiencies and errors
- Expedited processing requests when available
- Direct communication with payer credentialing departments
Re-Credentialing Services:
- Proactive monitoring of credentialing expiration dates
- Renewal application submissions 90-120 days before expiration
- Updated documentation collection and verification
- Continuous network participation without coverage gaps
- Re-attestation reminders and management
Additional Support:
- Multi-state credentialing for telehealth providers
- Credentialing status reports and timeline tracking
- Provider onboarding coordination with billing setup
- Tax ID and NPI enrollment assistance
- EFT (Electronic Funds Transfer) enrollment
Timeline: 60-120 days depending on payer and specialty requirements
Benefits:
- Start billing and receiving payments faster
- Avoid costly application errors and rejections
- Maintain continuous participation without lapses
- Free your staff from complex paperwork and follow-up
- Ensure compliance with all payer requirements