Credentialing and contracting are the basis of starting a clinic or healthcare facility. They also lay the root for your relationships with insurance companies as well as patients. For physician and organization reimbursement, it’s critical to have a designated, well-managed credentialing and re-credentialing service. And that is what you get with our team.
• Apply for all designated payers and follow-up until a determination by the payer
• Update and maintain CAQH database
• Update and maintain NPI database
• Apply for re-credentialing when due by each payer
• Medical License/DEA Registration/expirations
• Change from one practice to another
• Add a new physician to your existing group
• Want to become a network provider
• All state medical licenses
• Drug Enforcement Agency Certificate
• State Board of Pharmacy/Controlled Substance Certification (if applicable)
• All educational diplomas
• Board Certificate or Letter of Acceptance
• Current Curriculum Vitae
• Any other documentation required by the payer
• Hospital Affiliations Letter
• Bank information and voided check
Collect documentation and validate, Catalog and Store.
Identify top payers and file the application in payer-specific format.
Timely follow-up of application and obtain the enrollment.
Periodic updates of the payer documents for recredenialing.