CREDENTIALING DATA = REVENUE

We understand that credentialing is a critical part of the revenue cycle, and as a result, a critical component of the revenue that your organization collects.  Our approach is simple; Credentialing Data = Revenue. If you aren't credentialed correctly, you won't be paid correctly. Maximize every dollar possible with our expert credentialing services from our team in South Florida.

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comprehensive credentialing

OUR COMPREHENSIVE SOLUTIONS

Whether you work at a South Florida academic medical center, health system, are a hospital employed provider, or large group practice, our deep experience working with credentialing departments across the United States ensures that you will receive the best credentialing solution for your organization.

  • End to End Credentialing, Expirables Management and Re-Credentialing Solutions for all third party insurance, governmental, and CAQH payers
  • Expirables Management Solutions to maintain all time-sensitive credentials
  • Re-Credentialing Solutions for all third party insurance, governmental, and CAQH payers
  • Primary Source Verification (PSV)
  • Quality Assurance teams focused on preventing credentialing application rejections
  • Experienced Account managers to manage every aspect of the credentialing process
  • Assessments to identify improvement opportunities

INITIAL CREDENTIALING AND RE-CREDENTIALING SERVICES

  • On-site / Remote Primary Source Documentation collection using our secure scanning solution
  • Rapid data entry into our credentialing workflow software
  • Comprehensive Par/Non-Par Analysis to identify which providers are par and non-par
  • Missing Elements Review to ensure all proper documents required to enroll your physicians
  • Application and Signature Page Consolidation and Management
  • 100% Quality Assurance
  • Use of UPS, FedEx and/or Certified Mail to track and trend mailed applications
  • Dedicated Application Follow-up to ensure that are payers are actively processing your applications
  • Extensive Payer Contacts to escalate processing issues
  • Sophisticated Reporting designed to track and trend all stages in the physician credentialing life cycle
  • Compilation of all Provider Identification Numbers (PINs) for easy billing system entry

RE-CREDENTIALING SERVICES (FOR EXISTING PROVIDERS)

  • Conduct all re-credentialing services based on insurance plan requirements
  • 100% Quality Assurance
  • Application and Signature Page Consolidation and Management
  • Use of UPS, FedEx and/or Certified Mail to track and trend mailed applications
  • Dedicated Application Follow-up to ensure that are payers are actively processing your applications

credentialing

EXPIRABLES MANAGEMENT SERVICES

  • Pro-Actively Monitor Document Expiration (e.g., license, DEA registration, board certification)
  • Conduct all CAQH Re-Attestations (ever 120 days)
  • Expiring Document Report Analysis to ensure that you know in advance when a document is going to expire
  • Respond to Provider Enrollment Billing Issues/Edits

DELEGATED CREDENTIALING MANAGEMENT

  • Manage Delegated Credentialing Rosters for all delegated payers
  • Manage Weekly/Monthly Roster Submissions

SPECIAL PROJECTS

  • Medicare Re-Validation Services
  • Group Contract Creation and Enrollment
  • TIN Consolidation and Enrollment
  • Payer Website Analysis to ensure that your payers correctly list your provider data on their websites

Serving the entire United States and South Florida, including Boca Raton, Palm Beach, Delray Beach, Boynton Beach, Coral Springs, Deerfield Beach, Pompano Beach, Hallandale, Miami, Kendall, Vero Beach, Jupiter and all surrounding areas.