Physician Credentialing and Insurance Contracting

Physician Credentialing and Insurance Contracting 2018-09-11T20:18:13-04:00

Looking to develop and manage a wound care and hyperbaric program as an independent facility? Getting contracts from commercial and government entities can be a laborious and time-consuming process. See if our experts in this process can help you get on your way to a solid foundation of contracts for your services.

  • Review and assess current credentialing process if applicable
  • Determine the current status of each provider on all major insurances
  • Enroll each provider on available insurance panels
  • Establish and maintain provider binders throughout term of Agreement
  • Obtain provider information for CAQH such as: Medical License; DEA certificate; Liability Insurance; NPI number; etc
  • Submit all providers necessary applications and documents to obtain hospital privileges as required; maintain reappointments
  • Maintain re-credentialing of insurnace panels as required
  • NPI /CAQH registration and monitoring
  • Provider document maintenance: updating medical license, DEA's, CME, etc.
  • Medicare & Medicaid initial enrollement and revalidations
  • Contract negotiation; annual re-negotiations and upkeeping

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