We ensure that your practice or group has a diverse, popular, and effective mix of in-network payers. Our credentialing team is highly experienced in enrolling physicians with Medicare, Medicaid Managed Care plans, and all commercial payers. We contact each payer you want to enroll with to get accurate timelines and check if their panels are open..

We provide you with a complete checklist of all the necessary information and documents needed to submit your applications. Once we receive the details from you, our Enrollment team files the required contract applications and ensures everything is submitted correctly the first time, thanks to our vast experience. Because of our accurate submissions, we take pride in having one of the fastest turnaround times for getting contracts approved.

Our team checks in on the submitted application every two weeks to make sure it has been received and is in the payer's system. We also ensure that no extra information is needed and that everything is going smoothly. We continue to follow up regularly until the contract is finalized and delivered to your location..

Sometimes payers like UHC, Aetna, and BCBS have closed panels for labs in certain areas. When this happens, we send a detailed appeal highlighting the unique services you offer and how you provide exceptional patient care in your area. We include all these points in your business plan and submit it to senior provider representatives at the payer. While it's challenging to change closed panel decisions, we have a 30% success rate in doing so.

This service is for providers who choose not to join certain networks or are forced to stay out of network because of closed panels. Our team helps with out-of-network enrollments, including registering your NPI on the payer's website. This way, your medical practice is in the payer's system and can start receiving out-of-network payments.

We assist with both basic and complex demographic changes, like updating a new Tax ID with all the payers in your network, changing your address, or updating your bank account. We also help set up all ERA and EFT enrollments.

For larger healthcare facilities with multiple providers, managing an accurate provider database is crucial. We take care of all your providers' and physicians' credentialing data using our credentialing portal. This tool is comprehensive, transparent, and HIPAA compliant, designed to ensure your database is maintained with the highest efficiency and accuracy.

Keeping your PECOS and CAQH profiles up to date is essential in today’s healthcare world. Most major insurance companies now use CAQH to credential and enroll healthcare providers. We take care of setting up and maintaining your CAQH and PECOS profiles, ensuring your information is always accurate and compliant.