We provide optional Credentialing Services. We will work to make sure you are credentialed with your payers.
- Government programs – Medicare, Railroad Medicare and Medicaid
- Commercial – Aetna, Blue Cross, CIGNA, Humana, United HealthCare, WellPoint……
- IPAs and PHOs
This includes both the enrollment process and making sure your contracts have been completed.
If not already obtained, we will assist with the process of getting you and your practice Type I and Type II National Provider Identifiers (NPI). On an ongoing basis we will assist with linking NPIs to locations of care. This is critical for payment by Medicare. We will also assist with the periodic re-credentialing that many managed care plans undertake with their provider networks.
As part of the payer enrollment process we will establish your right for us to submit electronic claims and obtain both electronic remittances and electronic payments. For most of our clients over 99% of primary claims and 95% of carrier payments are handled electronically.
