Initial credentialing

Initial credentialing and new provider enrollment takes anywhere from 90-120 days to complete.  During this time, a provider is considered out-of-network.  After we file all of your initial applications and supplemental materials, we continuously follow up on your application status.  It is our duty to keep you informed.  Therefore, providers receive progress notes on a bi-weekly basis or by request.

During this time, a provider can still see their existing clients as we take care of all the paperwork and follow ups.  Once you are an approved provider you can either take the reins or allow us to help you post credentialing.  

consultations

As a provider, you are responsible for the full scope of any insurance contract you become a part of.  With that, you are still allowed to have questions.  In fact, you will have questions.  We can help you with those.

We can consult you on best practices, administrative guidelines, HIPAA and office privacy standards.  We also do the legwork of finding the answers for you if we don't have them.

Post credentialing

Life after initial credentialing does not stop.  After you have become an approved provider, you are still obligated to keep your contract up to date.  During the course of your contract, you will receive provider demographic updates as well as
re-enrollment or re-credentialing applications.

Each insurance panel varies on the frequency of these occurrences and depth of paperwork required.  We can help create the seamless flow of work by completing these items for you as they are received.  Using us for your post credentialing needs, not only ensures it is done correctly, but ensures it is completed in a timely manner, keeping your contracts up to date.

provider management

Beyond applications and credentialing, is the responsibility of managing yourself as a provider.  We provide data management of all of your information and help you navigate provider profiles.

In order to be credentialed for private insurance panels, you must hold a CAQH (Council for Affordable Quality Healthcare) profile.  This profile must stay up to date during and after your credentialing period.  We provide this service as part of our provider management. 

We also help you obtain provider profiles for insurance remittances, claims and provider portals.