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We are the experts

Working with various types of payor and provider organizations, we have the experience to help you maximize every dollar possible with our expert medical credentialing services. Whether its an academic medical center, health system, hospital employed provider, or large group practice, we are well versed in working with credentialing departments across the United States ensures that you will receive the best credentialing solution.

  • End-to-end credentialing, and re-credentialing solutions for all third party insurance, governmental and CAQH payors.

  • Expirables management solutions to maintain all time-sensitive credentials.

  • Re-credentialing solutions for all third party insurance, governmental and CAQH payor’s.

  • Quality assurance teams focused on preventing credentialing application rejections.

  • Experienced account managers to manage every aspect of the credentialing process.

  • Assessments to identify improvement opportunities.

Building a solid Foundation by doing things right from the start. credentialed physicians equals more revenue for your practice. It's critical that the process is both strategic and effective to ensure there are no delays for new or existing providers.

Initial credentialing and re-credentialing services

  • On-site/remote primary source documentation collection using our secure scanning solution.

  • Rapid data entry into our credentialing workflow software.

  • Comprehensive par/non-par analysis to identify which providers are par and non-par.

  • Missing elements review to ensure all proper documents required to enroll your physicians.

  • Application and signature page consolidation and management.

  • Use of UPS, FedEx and/or certified mail to track and trend mailed applications.

  • Dedicated application follow-up to ensure that are payor’s are actively processing your applications.

  • Extensive payor contacts to escalate processing issues.

  • Sophisticated reporting designed to track and trend all stages in the physician credentialing life cycle.

  • Compilation of all Provider Identification Numbers (PINs) for easy billing system entry.

Re-credentialing services

  • Conduct all re-credentialing services based on insurance plan requirements.

  • Application and signature page consolidation and management.

  • Use of UPS, FedEx and/or certified mail to track and trend mailed applications.

  • Dedicated application follow-up to ensure that are payor’s are actively processing your applications.

Expirables management services

  • Pro-actively monitor document expiration (e.g., license, DEA registration, board certification).

  • Conduct all ongoing CAQH re-attestations.

  • Expiring document report analysis to ensure advance notice that a document is soon to expire.

  • Respond to provider enrollment billing issues/edits.

Delegated credentialing management

  • Manage delegated credentialing rosters for all delegated payor’s.

  • Manage weekly/monthly roster submissions.

Special projects

  • Medicare re-validation services.

  • Group contract creation and enrollment.

  • TIN consolidation and enrollment.

  • Payor website analysis to ensure that your payor’s correctly list your provider data on their websites.

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