Network Research

We ensure the most varied, popular and effective in-network Payer mix for your group or practice. With extensive experience in enrolling physicians with Medicare, Medicaid, and Private Payers nationwide, our team reaches out to each shortlisted Payer that you want to enroll with and gets accurate timelines and open panel availability.

Application Filing

We send you a complete checklist of all the information and documents required to file the applications. As soon as the details are received, our Enrollment team files the appropriate contract applications, making sure it’s a flawless submission in the first go. Owed to our extensive experience and first-time correct application submissions, our clients experience the shortest turn around time in getting a contract.

Application Follow up

Our team follows up on the submitted application fortnightly, to ensure that the application has been received and is in the Payer’s system, that no additional information is being requested and everything is smooth. We follow-up regularly until the contract comes through and is delivered to your physical location.

Appeals for Closed Panels

Payers like UHC, Aetna, and BCBS sometimes have closed panels for a particular area. In such an instance, an extensive appeal that outlines the key points of your service, including niche services and details on how you bring exceptional patient care in your area is submitted to senior provider representatives at that Payer. While it is difficult to overturn a closed panel decision, we have had a 30% success rate with our appeals process.

Out-of-Network Enrollments

For providers that are forced to stay out of network due to closed panels or who choose to stay out-of-network with certain Payers, our team helps them with out-of-network enrollments and NPI registrations on the Payer’s website. This ensures the medical practice is in the Payer's system and can start receiving out-of-network payments.

Demographic Changes

Up-to-date PECOS and CAQH profiles are a necessity in today’s healthcare environment. All major Payers are going the CAQH route to credential and enroll medical providers. We maintain and upkeep your CAQH and PECOS profiles, making sure all your information is accurately profiled in and compliant.

Annual Credentialing Maintenance

For healthcare facilities with multiple providers, accurate provider database management is pivotal. We manage and maintain the credentials for all your providers and physicians on our credentialing portal. A comprehensive and transparent tool that is HIPAA compliant and specifically designed to ensure the upkeep of your database with utmost efficiency.

PECOS & CAQH Setup & Maintenance

Up-to-date PECOS and CAQH profiles are a necessity in today’s healthcare environment. All major Payers are going the CAQH route to credential and enroll medical providers. We maintain and upkeep your CAQH and PECOS profiles, making sure all your information is accurately profiled in and compliant.