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Premium Service
Network Research
We make sure your Practice or Group has the most varied, popular and effective in-network payor mix. Our credentialing team has extensive experience in enrolling physicians with Medicare, all Medicaid’s Managed Care plans along with all commercial payors. Our team reaches out to each shortlisted payor that you want to enrollwith and gets accurate timelines and open panel availability. This is one of our premium services that is available on request, at additional cost of $250.
APPEALS FOR CLOSED PANELS
Some major payors sometimes have closed panels for Labs for a particular area. We make sure to send an extensive appeal outlining the key points of your service, including niche services and details on how you bring exceptional patient care in your area. All these details are included in your business plan and submitted to senior provider representatives at that payor. While it can be difficult to overturn the closed panel decisions, we have a 30% success rate. This is one of our premium services that is available on request, at additional cost of $650.
OUT OF NETWORK
ENROLLMENTS
This is for all providers who choose to stay out of network with certain payors. Or if due to any closed panels, are forced to stay out of network. Our team helps with out of network enrollments, NPI registrations on the payor’s website etc. so that your medical practice is in the payor's system to start receiving out of network payments.
DEMOGRAPHIC CHANGES
We help with all basic and complex demographic changes such as updating a new TAX ID with all payors in your payor mix, updating a new address, bank account, etc. We also help set up all ERA and EFT enrollments.
ANNUAL CREDENTIALING MAINTENANCE
For larger healthcare facilities with multiple providers, accurate provider database management is pivotal. We manage and maintain all your providers’ and physicians’ credentialing data on our credentialing portal. It’s a very comprehensive, transparent and HIPAA compliant tool that we specifically designed to make sure we upkeep your database with the utmost efficiency and accuracy.
PECOS AND CAQH SET UP
AND MAINTENANCE
Keeping up to date PECOS and CAQH profiles is of utmost necessity in today’s healthcare environment. The biggest payors are all turning the CAQH route to credential and enroll medical providers. We maintain and upkeep your CAQH and PECOS profiles, making sure all your information is accurately profiled and compliant.
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