We provide comprehensive Credentialing & Contracting services designed to streamline the process of getting your practice and providers contracted with insurance networks. Our expert team manages the entire credentialing lifecycle, including CAQH and PECOS enrollment, I&A services, and Recredentialing, so you can focus on providing quality care.
Our Credentialing Services Include:
- We manage all aspects of credentialing, ensuring your providers are properly verified and meet the requirements of insurance networks and regulatory bodies.
- We conduct in-depth checks to verify education, licensure, certifications, and work history.
- We help you create, update, and maintain your Council for Affordable Quality Healthcare (CAQH) profile, which is used by many insurers for credentialing.
- We assist in enrolling and updating your information in PECOS (Provider Enrollment, Chain, and Ownership System) for Medicare participation.
- We guide you through the Initial and Active Enrollment processes with insurance carriers to ensure your practice is listed as an in-network provider.
- Our team handles the accurate and timely submission of all credentialing documentation to insurance companies, saving you valuable time.
Contracting Services:
- We assist in negotiating favorable payer contracts to help secure the best reimbursement rates and terms for your practice.
- We thoroughly review contracts from insurance companies to ensure the terms align with your practice's needs and financial goals.
- We manage your contracts by ensuring timely renewals and any necessary updates to keep them compliant.
Recredentialing:
To ensure your providers stay compliant and maintain participation with insurance companies, we manage Recredentialing processes. We handle the paperwork, monitor deadlines, and ensure all information is up-to-date to prevent any disruption in your ability to receive reimbursements.