Get In-Network Faster

ENROLLMENT
CONTRACTING
SERVICES
For Providers

Expand your pool of patients quicker and easier with the help of our dedicated team of enrollment and contracting experts.

— Get started in as little as 24 hours —

FEWER REJECTIONS

We know how to fill out
confusing payer forms.

Our provider enrollment experts get your contracts submitted the way in which payers want them. This means fewer rejections, less back-and-forth, and getting you in-network weeks or months faster than average.

SAVE TIME (AND MONEY)

Get in-network faster and without
hours and hours of followup.

You and your staff don’t have the time and resources to submit and follow-up with up to 10 payers. Enrollment with some providers can take as much as 9 months. Let us get you contracted weeks or months faster while you focus on your practice.

PROPRIETARY SOFTWARE

Quickly upload your documents,
let us handle the tedious forms.

Upload documents through our secure & encrypted proprietary software. We’ll walk you through our simple onboarding process to collect basic information, like W-9 & DEA numbers, and then we take care of the rest. This makes it easy for you to contract with many payers at once or add new payers in the future.

FEWER REJECTION

We know how to fill out confusing payer forms.

Our enrollment experts are certified PESC & get your contracts submitted the ways payers want them. This means fewer rejections, less back-and-forth, and getting you in-network weeks or months faster than average.

SAVE TIME (AND MONEY)

Get in-network faster and without hours and hours of followup.

You and your staff don’t have the time and resources to submit and follow-up with up to 10 payers. Enrollment with some providers can take as much as 9 months. Let us get you contracted weeks or months faster while you focus on your practice.

PROPRIETARY SOFTWARE

Quickly upload your documents, let us handle the tedious forms.

Upload documents through our PII compliant & encrypted proprietary software. We’ll walk you through our simple onboarding process to collect basic information, like W-9 & DEA numbers, and then we take care of the rest. This makes it easy for you to contract with many payers at once or add new payers in the future.

 

WE’RE PROUD TO
SERVE PROVIDERS
NATIONALLY

Maintenance Program for Providers

Starting at as little as $80/moInterruptions to your practice can cost you thousands or tens of thousands of dollars. Many providers aren’t always able to stay on top of their payers’ documents that need to be renewed yearly, and sometimes this means not getting paid by insurance companies for up to 30 days.

Ask us about our Maintenance Program and we’ll ensure your license, insurance, DEA, and other important documents are in good standing so you can focus on your patients.

YOUR CONTRACTING QUESTIONS. ANSWERED.

What services do you provide?
  • Provider Enrollment (Initial and Re-credentialing)
  • Medicare / Medicaid Enrollment and Re-validation
  • Facility Privileging (Appointment and Reappointment)
  • NPI and CAQH Set Up and Maintenance
  • Management of Expirables such as DEAs, Malpractice, and Licenses
  • Research and Analysis to Determine Enrollment Status, Individual Payer Requirements Based on Specialty and Geographic Location, and More
Credentialing, Enrollment, Privileging - isn’t it all the same?

Not really. While these 3 terms are often used interchangeably, they actually have different meanings:

Credentialing

    • , as defined by Joint Commission, is the process of obtaining, verifying, and assessing the qualifications of a practitioner to provide care or services in or for a health care organization. During this process, which is used by hospitals and health plans, a provider’s education, work history, licensing, malpractice history and more are reviewed assuring your patients that they are receiving quality healthcare.

Enrollment, also known as Provider Enrollment, is the process of obtaining participation within a health insurance network. During this process, a request to join the network is submitted to start the application process. You will then go through the credentialing phase, and once approved, move to the final phase of enrollment, which is contracting.

Privileging is the process of authorizing a healthcare provider to perform a specific scope of services and procedures at a healthcare organization. During this process, a provider may go through a 2-step application process beginning with the pre-application phase to identify providers who meet minimum requirements for staff membership and once approved they move to the application phase, which includes credentialing. When all of the information has been verified by medical staff services, recommendations are made regarding your appointment and privileges which is then presented to the Medical Executive Committee for final approval and granting of privileges.

How long does the enrollment process take?

Enrollment is a 2-step process – Credentialing and Contracting. The credentialing process typically takes about 60-90 business days from the time the application is submitted to the payer, with contracting taking an additional 30 business days once credentialing is complete. Because each payer’s process is different, this timeframe can vary and may be shorter or longer depending on additional factors such as provider specialty and current network needs. Our dedicated team of specialists works with each payer on a consistent basis to get you in-network as quickly as possible so you can start seeing patients and billing for services.

What information is required from me to start the process?

Our enrollment specialists will work with you to gather all of the information necessary to start the process as quickly as possible. Information typically required to complete an application includes addresses, phone and fax numbers, copies of all licenses, board certifications, education and employment history, peer references, and malpractice history. In addition, a number of payers now utilize CAQH (Council for Affordable Quality Healthcare) to streamline their enrollment process. If you do not already have a CAQH profile created our team can create one for you once we receive all of the necessary documentation.

Which insurance companies should I enroll with?

Insurance companies can vary depending on geographic location; however, in addition to Medicare and Medicaid, major national health plans to consider include:

  • Aetna
  • Anthem Blue Cross and Blue Shield
  • Centene
  • Cigna
  • Health Care Service Corporation
  • Humana
  • Kaiser Permanente
  • Molina
  • United Healthcare
  • WellCare
HOW IT WORKS

Step 1: Call Us

We’ll discuss what payers you and your practice want to work with.

Step 2: We’ll Take Care Of The Paperwork

We’ll handle all of forms & agressively follow up with payers, saving you and your staff weeks or months of waiting with hours of tedious follow-up.

Step 3: Start Seeing Patients Sooner

Get in-network and begin seeing patients sooner.

SPEAK TO AN EXPERT TO

GET IN-NETWORK FASTER

(855) 367-6559