Credentialing Services

What’s Included: (Quarterly Attestations)

  • Maintain current CV/ demographic updates
  • Primary Source verification
  • Maintain CME Activity and Report to Hospitals as Needed
  • Update Hospitals with Covering Physician Changes and Partnerships
  • Update All Credentialing Entities with License, DEA, CDS, Malpractice Insurance and Other Renewal Certificates
  • Background and CAQH maintenance
  • Set Reminders of Upcoming Expirables to avoid Loss of a License or Certificate
  • NPI Updates and Changes
  • Troubleshoot Denied Claims related to credentialing
  • New Enrollment and Contract Negotiations with Up to 3 Medicaid Plans
  • Top tier levels of reimbursements
  • Review contract Language
  • Evergreen renewals with a percentage increase every year
  • EFT and ERA enrollment
  • Global agreements (out of network that will pay at 5% billed charges for several third party reimbursement contractors.)

***There are many aspects to consider when negotiating a contract with a health plan. Most providers fail to examine these contracts in detail and settle for the standard language and rates. ***