Payer Contracting & Credentialing
Contracting & Credentialing vs Revenue Cycle Management
Revenue Cycle Management Services
- Credential Clinicians
- Credential New Programs
- Management of Organization Location & Staff NPI’s
- Representation for Contract Negotiations
- Consultation on regulations affecting payer types
- Provide support during county, state, or payer audits
- Specialized reporting including outcomes reports, staff productivity, and contract utilization management
- Patient demo entry, admits, discharges, expired treatment & service plan changes, and updates
- Multi-payer billing
- Electronic & Paper billing
- Resolve billing errors, rejections, and re-bill
- Post and track all-payer denials
- Follow up for denied claims
- Digital & Mailed Statements
- Online payment processing
- Providing closing reports
- Track and resolve outstanding issues
- Cleaning up un-submitted claims
Our Provider Support services cover payer contracting and provider credentialing, contract negotiation, and audit support.
For most practitioners and providers, credentialing is an essential part of joining a practice or a hospital’s medical staff and a part of becoming enrolled with insurance companies as an in-network provider. When credentialing is done poorly, portions of your revenue cycle management will be affected resulting in a loss of revenue.
You must keep in mind that all payers, healthcare organizations, and states have specific requirements for physician credentialing and enrollment. Although requirements and timelines differ from payer to payer, there are best practices that can be applied regardless of the administrative regulatory landscape
Revenue Cycle Management
We cater exclusively to the needs of medical professionals and allied health services. Our team of experts have knowledge in many…
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Medical Billing Software
We believe in 100% transparency with our clients, allowing them access to all activities regarding their billing and the ability to run reports at any time.