Our Credentialing Team caters but not limited to below:
– Provider / Group / Facility Enrollment with Payors
– Provider / Group / Facility Credentialing (Getting on Insurance Panels)
– Re-Credentialing
– Credentialing Appeals (Getting on Closed Insurance Panels)
– Revalidations
– (CAQH Completion, Management / Attestation)
– Primary Source Verification
– Hospital Privileging / Medical Staff Credentialing
– (Contract Procurement, Evaluation, Negotiation, Compliance, and Payment Auditing)
– Contract Negotiation (In and Out of Network)
– Contract Re-Negotiation
– (State and Federal Registrations and Certifications, Professional / Organizational Liability Coverage, Licensures, and other Credentialing Document Management)
– Sanctions Monitoring and Reporting
– Liaising between the Provider / Group / Facility and the Health plans / Payors.