Credentialing Services**

Credentialing and Staff Appointment:

• New provider information sheet set-up
• Practitioner demographic data
• Verification of credentials
• Appointment application process
• File review and staff appointment
• Appointment approval letter forwarded to Client

Health Plan Enrollment and Linkage:

• NPI and provider numbers obtained as necessary
• Enrollment and linkage applications completed and reviewed
• Cover letter generated
• Applications, cover letter, and all required attachments dispatched to insurers and tracked appropriately
• Follow-up initiated with each plan weekly until enrollment completed
• Notification of Client upon completion

Optional Credentialing Contract Maintenance:

• Maintaining active in-network status as a participating provider with all selected insurances
• Re-attestation of CAQH applications every 120 days, upon provider approval
• Completion of re-credentialing applications for unlimited number of carriers throughout the year, via phone, fax, mail and email requests, including Medicare/Medicaid revalidations.
• Working with Client staff on credentialing-related claims issues and problem resolution