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Contracting  and Credentialing Solutions

Some practices and facilities lack expertise in credentialing due to its infrequent occurrence. The absence of proper tools for proactive credentialing often results in reactive measures when claims start to deny due to non-participating or out-of-network issues.

Credentialing is a vital aspect of healthcare, regulated at state, federal, and payer levels. Our credentialing programs align with accrediting body standards.

 

As health systems expand, the need for solutions ensuring quick turnaround times, quality oversight, and compliance becomes imperative. We facilitate enrollment in insurance carrier networks, enabling you to deliver quality service to covered patients. Our tailored healthcare credentialing services expedite reimbursement.

 

Our professionals are well-versed in guidelines followed by major Medicare, Medicaid, and commercial insurance payers. We provide high-quality physician credentialing services, including form preparation, provider enrollment, tracking of CLIA, CAQH, DEAs, NPI, and Medical Association Registration, re-credentialing support, and document submission for faster approval, along with record and certificate verification.

Who We Work With...

  • Ambulatory Surgery Centers (ASC)

  • Audiologists

  • Behavioral Health Providers

  • Chiropractors (DC)

  • Clinical Laboratories

  • Dentists/ Orthodontists

  • Diagnostic Testing Facilities (IDTF)

  • Hospitals

  • Optometrists

  • PAs/ NPs

  • Physicians

  • Podiatrists (DPM)

  • PT/OT/SLP

  • Sleep Labs

  • Urgent Care Facilities

  • Many More

Provider Credentialing Services

RMS enrollment services are meticulously executed to meet and exceed industry benchmarks. We guarantee that physicians, practices, and facilities are seamlessly affiliated with insurance company networks, possessing the necessary practice qualifications to become eligible for payer reimbursement. Our application process undergoes regular evaluation to ensure strict adherence to insurance carrier terms.

 

As a technology-driven company, we provide secure solutions enabling our clients to share files and documents related to their projects in a protected and confidential manner. Our emphasis on security ensures that sensitive information is handled with the utmost care, maintaining the integrity and privacy of our clients' data throughout the enrollment process.

Credentialing Services Benefits

Our proactive monitoring system ensures timely notifications for expiring documents such as Professional License, DEA, Board Certification, and CME Hours. We implement CAQH re-attestations every 120 days to maintain up-to-date credentials. Our service includes comprehensive notifications and reporting for expiring documents, providing a detailed overview of the status of essential credentials.

In addition, we facilitate the resolution of claim issues and edits related to provider enrollment matters. Our dedicated approach ensures that providers maintain continuous compliance and are equipped to address any challenges related to their enrollment status. By staying ahead of document expirations and proactively managing re-attestations, we help streamline the provider enrollment process, reducing the risk of claim denials and enhancing overall operational efficiency.

Medical Billing

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