Assess documentation needs. We understand the health plan’s documentation requirements and start collating the physician credential information to support the documentation. We work with the physician to not only obtain their credentials but also reduce documentation burden by cataloguing the information.
We also identify and report any exceptions to the documentation requirements. We also make calls to physicians to obtain these documents.
We perform primary source verification such as criminal background checks, education, hospital admitting privileges, DEA certifications, National Provider Data banks, references, work history, and state licenses, using primary source verification engines provided by you.
Compile the application and submit. We compile the application in the formats desired by the payers by populating the information received
Periodic Follow-up with Payers. We follow-up with the payers on the submitted applications to expedite the credentialing process.
Maintenance of Provider Catalog for re-credentialing and updates. We maintain and update the provider data in a catalogue for use with other payers.