Credentialing and Contracting

1. Verification that all required licenses are up to date.

    a. Medical license

    b. DEA

    c. NPI

    d. Medical malpractice

    e. Other certificates

2. Creating CAQH,

3. Creating login information for all required websites,

    a. PECOS

    b. Availity

    c. Individual insurance websites 

    d. One Inc

4. Create and apply for credentialing for up to ten insurance companies. More can be added to the package.

5. Communication with the practice/provider weekly to update on credentialing progress.

1. Maintenance of  CAQH.
2. Verification of required license each year with notification before expiration dates.
3. Update governmental credentialing as required.
4. Update and maintain commercial insurance.
5. Malpractice verification.
6. Hospital credentialing as required by the client.

This is designed to support managers and billers who encounter difficulties in obtaining specific insurance credentialing.

It also applies to situations where providers are not receiving claim payments, despite having completed the credentialing process. 

We make multi-state credentialing easy. Whether your providers offer telehealth or practice in multiple states, we manage the process from start to finish.

• Experience with payer and state-specific requirements
   
• Fast, accurate enrollment across state lines
   
• Ideal for expanding practices and telemedicine
   

Let us handle the details so your providers can focus on care — wherever they are.

We take the guesswork out of payer contracts by proactively requesting the most current agreements and all applicable addendums. Whether you're unsure what’s on file or want to double-check for updates, we ensure your records are complete, up-to-date, and easily accessible.

Having the correct version of each contract is essential for protecting your revenue, avoiding compliance issues, and knowing exactly what you’ve agreed to — and we make sure nothing slips through the cracks.

 We conduct a thorough review of proposed contracts, analyzing both fee schedules and contract language to identify risks, inconsistencies, and terms that may impact your practice. As part of the process, we create an easy-to-read spreadsheet highlighting key items — including reimbursement rates, term lengths, renewal clauses, and any red flags — so you can make informed decisions with confidence. 

 Using clear financial analysis, we outline how proposed fee schedules impact your revenue. We then collaborate directly with payers to negotiate stronger reimbursement rates and more favorable terms that reflect your value and align with your financial goals.

Our focus is to ensure every contract contributes to the financial health and long-term success of your practice.