We will collect and submit credentialing documents for licensed providers to send to state commercial health plans and National Behavioral Health Carriers (Blue Cross/Blue Shield, Aetna, CIGNA, OPTUM/United Healthcare) of your choosing, individual and group enrollment in Medicare (LPC are not eligible) and/or Medicaid, and Medicaid CCOs in your area.  We can also help maintain and update CAQH and web portals.  We can also maintain and submit provider rosters for unlicensed providers as allowed by state.

Our medical credentialing services include:

• Provider enrollment services for physicians and healthcare entities (credentialing and contracting with health plans)
• Medicare provider enrollment and re-validation services
• Credentials verification for physicians and ancillary healthcare providers
• Network management for health plans
• Outsourced hospital privileging (outsourced medical staff office)
• Managed care contracting
• Annual maintenance needs; CAQH, updating the health plans w/ liability/licenses, and re-credentialing
  • We offer a discounted rate for annual maintenance for unlicensed providers, like Qualified Mental Health Associates (QMHA) and Qualified Mental Health Professionals (QMHP)

Our staff will work with any insurance companies to get your practice providers enrolled with health plans and to maintain your providers credentialing files.

• All Specialties
• All Commercial Insurances
• All Government Payers (Medicare and Medicaid)
• Nationwide Including Alaska, Hawaii and Puerto Rico
• Re-credentialing and Re-validations
• CAQH Setup
• Web portal set-up for sites as needed
• NPI & Group NPI setup