- Eligibility and Benefits Verification
- Patient Demographics Entry
- Charge Entry
- Medical Coding Services
- Claims Submission Work Edits and Rejection
- Payment Posting Services
- Accounts Receivable Management
- Denial Management Services
- Coding Denial Management
- Credit Balance Services
- Patient Statement Services
- Revenue Cycle Analytics
Tailored Provider Credentialing and Enrollment Services
Physicians and providers must undergo a thorough credentialing process to enroll and attest with Payer networks, ensuring they are authorized to deliver services to patients covered by the Payer’s plans. Credentialing validates a physician’s ability to meet clinical care standards, encompassing factors like education, licensure, experience, certifications, affiliations, malpractice history, and training.
Why Credentialing Matters:
Payers may withhold or delay payments to non-credentialed physicians, adversely affecting practice finances. Our customized Provider Credentialing and Enrollment services aid physicians in various scenarios, including:
- Starting or joining a new practice
- Transitioning between physician practice groups
- Joining or affiliating with new groups/practices
- Enrolling with additional payers
- Maintaining ongoing credentialing needs.
Our Credentialing Process Includes:
- Gathering necessary data and documents for credentialing applications from physicians
- Securely storing documents on our centralized document management systems
- Initiating contact with top payers and applying payer-specific formats post-audit
- Conducting timely follow-ups with payers to track application status
- Communicating enrollment numbers and application statuses to physicians
- Regularly updating document libraries for ongoing credentialing needs.
Benefits of Our Services:
- Expedited credentialing with major payers
- Reduced claim denials and enhanced cash flow
- Increased patient referrals from network participation
- Streamlined paperwork with our document management system
- Assistance with complex application forms
- Cost savings through our global delivery teams
- Timely status reports on application progress.
