Services
I will be your single point of contact for all credentialing services. I know how to take the complex task of credentialing and make it a seamless process for my exclusive list of clients. LETS CHAT! (225-308-1751). I will answer all questions and/or concerns you have about credentialing no matter where you are in the process.
I will be your single point of contact for all credentialing services. I know how to take the complex task of credentialing and make it a seamless process for my exclusive list of clients. LETS CHAT! (225-308-1751). I will answer all questions and/or concerns you have about credentialing no matter where you are in the process.
Space is limited.
Space is limited.
Provider Enrollment
Provider Enrollment
Provider Enrollment ensures the providers are approved for reimbursement from healthcare plans. Only providers who are properly enrolled can bill for covered services and receive in-network reimbursements. My credentialing service is completed when you receive the correct reimbursement from the payor.
Provider Enrollment ensures the providers are approved for reimbursement from healthcare plans. Only providers who are properly enrolled can bill for covered services and receive in-network reimbursements. My credentialing service is completed when you receive the correct reimbursement from the payor.
Onboarding- We will meet to discuss the payors you wish to enroll and I will offer recommendations. We will review the credentialing service agreement to assure we're on the same page. I will provide you a list of items needed to initiate the credentialing process and I will address any questions or concerns you may have.
Onboarding- We will meet to discuss the payors you wish to enroll and I will offer recommendations. We will review the credentialing service agreement to assure we're on the same page. I will provide you a list of items needed to initiate the credentialing process and I will address any questions or concerns you may have.
Application- I will confirm with the payor the proper process for your unique situation. My goal is to get it right the first time so there's no need to resubmit or start over. I will complete and submit the paperwork required by the payor
Application- I will confirm with the payor the proper process for your unique situation. My goal is to get it right the first time so there's no need to resubmit or start over. I will complete and submit the paperwork required by the payor
Follow-up- I will follow-up with the payors to assure the application moves forward in the process. My tracking system allows you to follow alone. You will have access to my notes and get real-time updates of your credentialing status.
Follow-up- I will follow-up with the payors to assure the application moves forward in the process. My tracking system allows you to follow alone. You will have access to my notes and get real-time updates of your credentialing status.
Contracting- I will forward you the contracts and fee schedules the payors provide for review and approval. If assure you will be informed throughout the process.
Contracting- I will forward you the contracts and fee schedules the payors provide for review and approval. If assure you will be informed throughout the process.
Enrolled- I will inform you of the approvals as I received them. At this point you can start billing the payors.
Enrolled- I will inform you of the approvals as I received them. At this point you can start billing the payors.
Completion- I will check in with you to assure your claims payments are received and correct.
Completion- I will check in with you to assure your claims payments are received and correct.
Group Enrollment
Group Enrollment
Group Enrollment ensures the group's TAXID and NPI are registered with the payors. This allows the providers to bill and get reimbursed under the group and links the providers to the group's contract.
Group Enrollment ensures the group's TAXID and NPI are registered with the payors. This allows the providers to bill and get reimbursed under the group and links the providers to the group's contract.
Group Contracts- Most payors requires at least two enrolled providers before you can request a group contract. A group contract will allow the group to add and remove providers from the group as needed. This will also shorten the contracting phase because the providers will not need individual contracts. If a provider is not credentialed, the provider will need to complete the credentialing phase before the provider can be linked to the group's contract.
Group Contracts- Most payors requires at least two enrolled providers before you can request a group contract. A group contract will allow the group to add and remove providers from the group as needed. This will also shorten the contracting phase because the providers will not need individual contracts. If a provider is not credentialed, the provider will need to complete the credentialing phase before the provider can be linked to the group's contract.
Multispecialty Group Contracts- The format of the contract will be determined by the payor. Some payors will allow multiple specialties under a single contract while others will require a separate contract for each specialty.
Multispecialty Group Contracts- The format of the contract will be determined by the payor. Some payors will allow multiple specialties under a single contract while others will require a separate contract for each specialty.
Fee Schedules- The fee schedules will be included with the contract and will cover all specialties listed on the contract. In most cases a sample fee schedule is provided but fees can be provided for a selection of procedure codes if needed. All providers in the group will be reimbursed the same rates per their specialties.
Fee Schedules- The fee schedules will be included with the contract and will cover all specialties listed on the contract. In most cases a sample fee schedule is provided but fees can be provided for a selection of procedure codes if needed. All providers in the group will be reimbursed the same rates per their specialties.
Who do I served
Who do I served
I have provided credentialing services for several specialties, for new practices and existing practices. I'm experienced working with Medicaid, Medicare, MCOs and Private Payors in several states.
I have provided credentialing services for several specialties, for new practices and existing practices. I'm experienced working with Medicaid, Medicare, MCOs and Private Payors in several states.
Physicians
Nurse Practitioners
Dentists
Counselors and Psychologist
Physical, Occupational, Speech Therapists
Dietitians
Chiropractors
Specialists and Primary Care Providers
Additional Credentialing Services
Additional Credentialing Services
New Practice Setup
Telehealth Enrollments
Multi-state contracting
Payor Contract Negotiations
CAQH Completion and Management
Delegated credentialing
Recredentialing
Availity Setup and Management
Provider Portal setup and Management
EFT Setup
Payor Updates (Additions or Changes)
Add practice locations with insurance carriers
Payor Directory Updates
Retrieve fee schedules
Obtain rosters
Appeal closed insurance panels
Track License, Insurance and Board renewals
Experienced working with the following applications: PECOS, CAQH, NPI Registry, Modio. CredSimple, Intellicred. Statcred, AndrosCVO, VeritystreamCVO and MDStaff