Placement of Providers on Managed Care Networks, Malpractice Insurance, Medicare, Medicaid and Hospital staffs
List of Services included in Initial Set up Fee and On-going Monthly Service Fee:
* Complete and submit on provider's and/or organizations's behalf, all Initial and RE-credentialing applications and contracts including Managed Care Networks, Medicare, Medicaid, ARNP Protocols, Malpractice Insurance, and Hospital Medical Staffs. This is for unlimited amount of applications. Includes follow-up on a monthly basis as needed to process quickly and efficiently.
* Obtain and update as needed the NPI(National Provider Identifier numbers) for Group's and/or Individual Providers.
* Update DEA, AMA Profile, State Professional Licenses as needed (change of address, etc).
* Obtain and submit NEW Managed Care Contracts and applications on-going as new markets appear or change in your area.
* Obtain CAQH ID number(if applicable) and update on-going, and/or complete and submit provider's CAQH or other State Standarized applications to all eligible managed care networks in your area. Updates, for example would include uploading renewed copies of the provider's credentials such as their State Professional, CDS or DEA licenses or updating a new billing address or new practice location, etc.
* Email or fax updated credentials to the provider's hospitals and managed care networks.
* Notify the Managed Care Networks, the NPI, CAQH, Hospitals, Malpractice Insurance, Medicare and Medicaid, etc. of any change of addresses, phone and fax numbers, submit updated W9 forms, and change of address forms. **NOTE: Change of Tax ID number requires new contracts and new applications to be submitted which means that Initial set up fees will apply. Any other type of practice changes that occur are covered under the on-going Monthly service fee.
* Terminate Medicare reassignments from previous employers and/or de-link your Medicaid number from your previous employer as well. (as requested).
* Obtain completed Peer Reference forms for provider's hospital and managed care applications.
* Respond to all Credentialing requests for additional documentation from hospitals, Medicare, Medicaid, and managed care networks.
* CME/CEU Tracking: Includes set up of account with your State Board of Medicine, submission of certificates, hours and reporting of hours as needed
each month to be in compliance for State License Renewals. Will advise provider what their requirements are for their specialty near renewal time. Providers
will take the courses themselves and submit the certificates to us for submission, tracking and reporting.
* ARNP Protocols-complete and submit to the State Board of Nursing a provider's ARNP protocol as needed initially or at renewal. Also, notify the Board of Medicine of initial protocols, any changes to a protocol and/or termination of protocols.
* Set up of group or provider in Access database and keep track of provider's User ID and passwords for CAQH, NPI, Medicare, Medicaid, etc. Create Office Roster in Word and develop reports in Excel and Word listing your current Managed Care networks and Hospitals. Managed care reports are sent via email to providers monthly, as they are updated or as requested by the provider or group. These reports are also sent to your Billing Representatives so that they are also aware which Managed Care Networks and Hospitals you are currently participating in or on staff.
* Help resolve Billing issues that may arise from time to time working with the provider's Billing Dept. or Billing Representative.
FEES NOT INCLUDED IN OUR INITIAL SET UP FEES AND ON-GOING MONTHLY SERVICE FEES:
* Application fees for hospital, malpractice insurance, Medicaid background checks, and managed care applications including but not limited to: verification fees, ABMS fees, fingerprint background fees, State Licensing application fees, State Licensing Verification Fees, CME/CEU fees or any other fees imposed in the processing of Credentialing paperwork.
* Obtain and update as needed the NPI(National Provider Identifier numbers) for Group's and/or Individual Providers.
* Update DEA, AMA Profile, State Professional Licenses as needed (change of address, etc).
* Obtain and submit NEW Managed Care Contracts and applications on-going as new markets appear or change in your area.
* Obtain CAQH ID number(if applicable) and update on-going, and/or complete and submit provider's CAQH or other State Standarized applications to all eligible managed care networks in your area. Updates, for example would include uploading renewed copies of the provider's credentials such as their State Professional, CDS or DEA licenses or updating a new billing address or new practice location, etc.
* Email or fax updated credentials to the provider's hospitals and managed care networks.
* Notify the Managed Care Networks, the NPI, CAQH, Hospitals, Malpractice Insurance, Medicare and Medicaid, etc. of any change of addresses, phone and fax numbers, submit updated W9 forms, and change of address forms. **NOTE: Change of Tax ID number requires new contracts and new applications to be submitted which means that Initial set up fees will apply. Any other type of practice changes that occur are covered under the on-going Monthly service fee.
* Terminate Medicare reassignments from previous employers and/or de-link your Medicaid number from your previous employer as well. (as requested).
* Obtain completed Peer Reference forms for provider's hospital and managed care applications.
* Respond to all Credentialing requests for additional documentation from hospitals, Medicare, Medicaid, and managed care networks.
* CME/CEU Tracking: Includes set up of account with your State Board of Medicine, submission of certificates, hours and reporting of hours as needed
each month to be in compliance for State License Renewals. Will advise provider what their requirements are for their specialty near renewal time. Providers
will take the courses themselves and submit the certificates to us for submission, tracking and reporting.
* ARNP Protocols-complete and submit to the State Board of Nursing a provider's ARNP protocol as needed initially or at renewal. Also, notify the Board of Medicine of initial protocols, any changes to a protocol and/or termination of protocols.
* Set up of group or provider in Access database and keep track of provider's User ID and passwords for CAQH, NPI, Medicare, Medicaid, etc. Create Office Roster in Word and develop reports in Excel and Word listing your current Managed Care networks and Hospitals. Managed care reports are sent via email to providers monthly, as they are updated or as requested by the provider or group. These reports are also sent to your Billing Representatives so that they are also aware which Managed Care Networks and Hospitals you are currently participating in or on staff.
* Help resolve Billing issues that may arise from time to time working with the provider's Billing Dept. or Billing Representative.
FEES NOT INCLUDED IN OUR INITIAL SET UP FEES AND ON-GOING MONTHLY SERVICE FEES:
* Application fees for hospital, malpractice insurance, Medicaid background checks, and managed care applications including but not limited to: verification fees, ABMS fees, fingerprint background fees, State Licensing application fees, State Licensing Verification Fees, CME/CEU fees or any other fees imposed in the processing of Credentialing paperwork.
