Our Services
Need to add a new provider to your group's contract?
Want to be in-network with a new payer?
Adding a new location to your TIN?
Services are customized to fit each client's needs -
whether it's adding new providers who have never been credentialed,
removing providers who are no longer with the group,
adding credentialed providers to your group,
or adding a group location to your existing contract.
We have established relationships with these insurance payers:
Aetna, Anthem, BlueCross BlueShield,
Cigna, Delta Dental, EyeMed, Forward Health, Guardian,
HealthPartners, Hennepin Health, Humana,
Medica, Medicaid, Medicare, Optum, Prime West, Sanford, SecureCare, Tricare,
UCare, United Behavioral Health, United Healthcare, WPS,
and others.
Why choose us?
-Increase your revenue
-Reduce claim denials
-Reduce your administrative costs
-Fixed prices for application submissions
-Monthly notice for expirable documents
-Knowledgeable and available staff
Let us know how we can help!
Contracts
Contracting is the process of applying for and obtaining participation with insurance payers. Contracts are vital to insurance-based groups if they want to operate with ease. Having a contract in place will contribute to patient and staff satisfaction, as well as timely and proper reimbursements.
Our contracting services can include:
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Gathering the necessary information and documentation
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Application completion and submission
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Medicare enrollment
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Medicaid enrollment
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Regularly scheduled follow-up
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Detailed payer communication log
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Effective dates chart
Some providers want to remain out of network with certain payers. Others, due to closed panels, are forced to stay out of network. While you are waiting for the panel to reopen, we can get you registered or certified with the payer so that your practice is in their system to start receiving out-of-network payments.
Credentialing
Credentialing is the process of gathering and verifying the qualifications and competence of a healthcare provider. Proper credentialing is required by all healthcare accreditors. It ensures patient safety, reduces medical errors, and is essential if you want to be in network with insurance companies.
Recredentialing
Recredentialing and revalidation are processes that are completed when a payer requests a review of a provider’s qualifications and history. It is required to remain in the insurance network and is performed routinely after initial credentialing.
Our credentialing and recredentialing services can include:
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Provider onboarding and internal file set-up
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Populate or update credentialing profiles
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Attestations
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Submission of applications
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Regularly scheduled follow-up
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Effective date email confirmations
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Detailed payer communication log
Demographic & Directory Updates
It's important to keep group and provider rosters up to date to maintain accuracy in insurance payer systems. This allows patients to easily find providers on the payer websites, ensures only current providers are enrolled, and secures proper reimbursement.
These services include:
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Changing a provider's legal name
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Adding/deleting a practice location
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Change a practice location address
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Clinic closure
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Removing a provider from the group's contract
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Changing the group's name
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Updating phone/fax for group
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and more.
Detailed logs are kept for tracking progress and follow up. Confirmations are shared with the group's designated contact.