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Informed Contracting It is true that if you are a PCP in the St. Louis metro area, many health plans offer a "take it or leave it" contract. But this isn't true with all specialties and in all geographic areas. When in the contracting process, rates are indeed important. But rates aren't everything. Contract language has a significant impact on your administrative burden.
Proper Enrollment Means Timely Reimbursement The healthcare industry is in a state of continuous evolution. Part of this evolution is heightened attention to the process of credentialing. Ensuring that providers are enrolled appropriately in health plans is a key function to guarantee timely reimbursement. Further, payers are paying much closer attention to those providers who are suspected of having been sanctioned by any of their peers.
Effective and Efficient Credentialing With Medicare requiring re-validation of all providers every three years, and managed care companies requiring it every two years, more and more focus will be directed toward effective and efficient credentialing. Our process requires very little effort or time from the provider and has been very well received by our clients.
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