Provider Credentialing & Enrollment Services
Provider Enrollment
Compliance Assurance
Network Inclusion
Privilege Maximization
Provider Credentialing & Enrollment Services
Provider Enrollment
Compliance Assurance
Network Inclusion
Privilege Maximization
Better Pricing
Fast Track Credentialing
Dedicated Resource Allocation
Compliance With Federal & Commercial Payors
Better Pricing
Fast Track Credentialing
Dedicated Resource Allocation
Compliance With Federal & Commercial Payors
Why is credentialing important?
Medical credentialing has become increasingly important in healthcare as practices, health organizations and among individual providers as they look for ways to ensure patient safety, increase revenue, and protect healthcare institutions from harm. Confirming the qualification of healthcare professionals through credentialing can save healthcare organizations from liabilities, fiscal losses, incompetent providers, and unwanted lawsuits. That’s why every healthcare professional should consider being credentialed with as many insurance providers as possible if they want access to more patients.
Why is credentialing important?
Medical credentialing has become increasingly important in healthcare as practices, health organizations and among individual providers as they look for ways to ensure patient safety, increase revenue, and protect healthcare institutions from harm. Confirming the qualification of healthcare professionals through credentialing can save healthcare organizations from liabilities, fiscal losses, incompetent providers, and unwanted lawsuits. That’s why every healthcare professional should consider being credentialed with as many insurance providers as possible if they want access to more patients.
RCM Works – Your Go-To Partner in Credentialing and Beyond
The traditional approach to credentialing often involves a tedious and error-prone manual process, leading to delays, inefficiencies, and potential compliance risks. The result? Lost revenue opportunities, frustrated staff, and strained financial performance. RCMW provides a hassle-free and stress-free credentialing strategy, prioritizing your reimbursement rates. Our focus is on getting you covered with all plans coming under insurance panels while you focus on your clients. With a track record of credentialing thousands of professionals, we are eager to assist you with your credentialing needs.
Our Process …..
Provider/Group Credentialing
It all starts with carefully reviewing and verifying your documents to attest they are accurate and meet all the necessary requirements. We ensure that your practice is properly credentialed and compliant with both state and federal regulations so you are able to provide high-quality services while meeting all necessary requirements.
Contracting & Negotiations
Navigating the complexities of securing favorable contracts and maximizing compensation can be challenging. Our expertise in reimbursement rates, market value, and contractual terms ensures successful negotiations, meticulous contract crafting and ultimately, the attainment of the higher reimbursements for you.
Provider Linkage
Imagine a world where CAQH maintenance is a breeze – where updates and verifications happen seamlessly. We make this possible by automating your entire CAQH process, ensuring that all provider’s profiles are up-to-date and compliant. Our team efficiently manages the renewal process, updates credentialing information, and resolves any issues that may arise.
CAQH Maintenance
Imagine a world where CAQH maintenance is a breeze – where updates and verifications happen seamlessly. We make this possible by automating your entire CAQH process, ensuring that all provider’s profiles are up-to-date and compliant. Our team efficiently manages the renewal process, updates credentialing information, and resolves any issues that may arise.
License Renewals
This process involves obtaining a license from the relevant state authority in the area where the provider wants to provide their services. Our certified resources can help physicians complete all of the required steps, including submitting CME certificates, providing health status documentation, and disclosing any disciplinary actions.
Effortless EDI Setup
We streamline and automate the entire EDI, ERA, and EFT setup process for seamless electronic data interchange for claims, remittance advice, and payments. Embrace the simplicity, efficiency, and financial optimization that come with it.
Follow Ups
Follow-ups are to be the most crucial part if you want to get things done on a fast track. Our team ensures to do these on a weekly basis to stay ahead of the game while keeping you well informed on your applications.
Add-On- Services
ADDING PROVIDERS
We recognize that it may take 90-180 days to have your provider credentialed, and our credentialing team is committed to submitting all required materials quickly to ensure timely enrollments.
PRACTICE CONSOLIDATION
Although new providers may be credentialed under their previous practice, certain requirements still need to be met if the provider is new to the practice. Don’t forget this important step to ensure your new providers receive timely payments from insurers
MOVING OR ADDING PRACTICE LOCATIONS
Our demographic change services can complete the necessary paperwork to update physician credentials with any payer
STAFF TIME CONSTRAINTS
Provider o ce employees often are responsible for credentialing while juggling other tasks. Let us take over this workload so they can focus on other tasks
EXPANDING PAYER NETWORKS
Adding additional payers to the mix can increase the client base for practices by accepting additional insurances, and our team can help make it a painless process.
MERGERS AND ACQUISITIONS
If you’re building a business, providers must be re-credentialed as part of a merger or acquisition. Get it done quickly with the help of our experts.
RE-CREDENTIALING CURRENT PROVIRES
If you’re building a business, providers must be re-credentialed as part of a merger or acquisition. Get it done quickly with the help of our experts.
Insurances
