Credentialing
• Credentialing services for new providers.
- Provide credentialing services for the provider and allied health professionals utilizing primary source verifications.
- Change tax ID, address and pay-to location with existing health plans.
- Enroll the provider in multiple Medicare and Medicaid locales.
- Enroll the provider in the MedicalEdge group managed care plans, term existing contracts.
- Manage hospital privilege applications.
- Manage CAQH database and compliance (utilized by major health plans).
- Obtain and manage NPI number and coordinate use with health plans.
- Change address with DEA and other applicable agencies.
File CLIA and other applications for new offices.
• Credentialing services for all providers.
- Manage credentials expiration alert system.
- File compliance forms and protocols for allied health professionals with appropriate boards.
- CLIA renewals.
- Maintain provider credential files.
- Manage provider numbers.
- Process hospital and managed care reappointments.
• General.
- Assist with payer issues.
- Create monthly managed care grids.
- Process membership, licensure, society and CME dues and fees.