Our Credentialing Management Services include:
√ Maintain Credentialing documents and Contracts
√ Reminders on Licensure and Certification expirations
√ Update CAQH
√ Re-Credentialing Management
√ Maintain data is up to date with all insurance accepted
Why you will benefit from our management services:
Credentialing is essential to receiving payments from your client base. If you plan to accept insurance, you must be credentialed with most insurance companies to receive reimbursement. We will help you gain credentialing and contract with each insurance company you decide to use. Providers and health plans are riddled with redundancy, with many organizations collecting virtually identical information. The typical physician spends more than three hours annually submitting nearly 18 different credentialing forms with staff spending an additional 20 hours. We will complete all of the work for you, without the hours taken away from your day.
Dependent Provider and Licensed Independent Practitioner Credentialing Management:
Credentialing Management Solutions will verify education, licensures, certifications, references, and employment history of all licensed and/or certified employees within your practice. Primary Source Verification will be used with each employee and/or potential new employee. Our services will also include with membership, an alert for each Dependent and
Licensed Independent Practitioner’s Licensure and/or Certification Expiration Date. These alerts will be sent to you at a 90 day, 60 day, 30 day and 10 day notice. My team will notify you of any adverse licensure actions with the licensure each month. Regular verification of the credentials of health care practitioners and definition of their privileges are required for increased patient safety, reduction of medical errors and the provision of high quality health
care services. The AAAHC requires credentialing of all licensed healthcare practitioners. The Federally Supported Health Centers Assistance Act of 1992 (Act) requires that each deemed Health Center that participates in the FTCA must credential all its physicians and other licensed or certified health care practitioners.
Managing the application process:
For our Credentialing service clients we will manage the application process to contract with insurance plans such as: Aetna, Anthem, Blue Cross and Blue Shield, Cigna, Humana, Medicaid, Medicare, TriCare, United Health Care and many other insurance plans that your Practice intends to use.