US24 Healthcare simplifies the process of getting a provider credentialed with payers. With our Provider Credentialing Services, you can keep your data up-to-date and follow up on any questions or issues in just one place!

PROVIDER CREDENTIALING

The process involves the following steps:

• • Application Evaluation. Completing required documentation and identifying exceptions.

• • Primary Source Documentation. Verify practitioner/ facility information from physicians.

• • Outbound Call Center. Obtain missing documents and update the payer’s database.

• • Follow-up with payers. Follow-up on submitted credentialing requests.

• • Data Entry. Capture data, label, and link images to specific providers/ facilities in the payer’s database.

• • Maintenance of Provider Data. Update provider information as per policies and procedures, and CAHQ profile.

PROVIDER ENROLLMENT

The process involves the following steps:

• • Verification of provider information. Contact payers to determine if they have the correct provider information on file before we submit claims

• • Updating practice’s Pay-to address. Validate and update the provider’s pay-to address or the billing address

• • Enrolling in electronic transactions. Our team can enroll providers for four types of electronic transactions:

1. 1. Electronic Data Interchange (EDI)

1. 1. Electronic Remittance Advice (ERA)

1. 1. Electronic Fund Transfer (EFT) and

1. 1. CSI

• • Monitoring process. A group of highly skilled team members trained to perform research and analysis on the possible processor functionality gaps.

Why Enrollment and Credentialing Services

• • Avoid junk of paperwork and filling out application forms

• • Building relationships with different payers.

• • Track real-time status of credentialing and enrollment transactions.

• • Process faster payments from insurance and get more patient referrals.

• • Lower the risk of revenue leakage.