Solid State Practice

Credentialing & Enrolment

Provider credentialing is the process of getting a physician or a provider associated with payers. It is a critical step in revenue cycle. It enables the provider to get reimbursed for the medical services provided to patient, it is important for healthcare providers to get enrolled and credentialed with maximum payers so that patients can use their insurance policy in the practice Effective Credentialing Services which is the absolute necessity for good practice. Without proper enrolment, payments can be delayed or refused by the insurances, even if the physician is able to provide services that are competent and medically necessary.

 Completing Application with required documentation

 Verifying practitioner / facility information from physicians.

 Obtain missing documents and updating the insurance carriers.

 Follow-up on submitted Applications

 Updating provider information as per policies and procedures, and CAHQ profile.

 Updating contracts with payers

Not Found

Collect Documentation And Validate Catalog And Store.

Documentation

Collect documentation and validate, catalog and store.

Payer Submission

Identify top payers and file the application in payer-specific format.

Ensure Enrollment

Timely follow-up of application and obtain the enrollment.

Updates & Credentialing

Periodic updates of the payer documents for recredentialing

Solid State Practice