Contracting  and Credentialing Solutions

Some practices/facilities lack expertise in this area because it is a function that is not performed with much regularity. The lack of the necessary tools to properly and pro-actively manage the credentialing process leads to reactionary measures that are enacted only when claims begin to deny due to non-participating and/or out of network issues.

Credentialing is an essential part of healthcare and is highly regulated at the state, federal, and payer levels. Our credentialing programs comply with accrediting body standards.

 

Health systems continue to grow and consolidate, the demand for solutions that guarantees quick turnaround times, quality oversight, and compliance are now a requirement.

We can help you get enrolled with insurance carrier's network so that you can provide quality service to patients who are covered by the carrier. Our tailored healthcare credentialing services will help you get reimbursed faster.

Our professionals are adept at guidelines followed by many leading Medicare, Medicaid, and commercial insurance payers. We offer high-quality physician credentialing services that will help with the following:

  • Form preparation based on insurer guidelines

  • Provider enrollment formalities and credentialing

  • Tracking CLIA, CAQH, DEAs, NPI, and Medical Association Registration

  • Re-credentialing support

  • Form and document submission for faster approval

  • Record and certificate verification

  • Aggregation of document and certification details coupled with the preparation of application forms

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 executed by meeting industry benchmarks. We ensure that physicians, practices, and facilities are affiliated with insurance companies networks and possess relevant practice qualifications for becoming eligible for payer's reimbursement. The application process is periodically evaluated to ensure adherence to insurance carrier's terms.

Being a technology driven company we offer a secure solutions that lets our clients share files and documents related to their projects in a secure way.

Credentialing Services Benefits

  • Pro-active monitoring and notification of expiring documents (e.g., Professional License, DEA, Board Certification, CME Hours)

  • CAQH re-attestations (every 120 days)

  • Expiring document notifications and reporting

  • Facilitate claim issue and edits related to provider enrollment issues