Credentialing & Contracting

Insurance Credentialing Services

PractiSynergy provides credentialing, privileging and contract negotiating services for small to mid-sized medical providers reducing the administrative nightmare of the process and increasing reimbursements in provider contracts. On-going maintenance and monitoring ensures provider network status does not lapse.

New Providers
Includes up to 12 third party payers and 4 facilities for privileges *If you contract with PractiSynergy for your medical billing, a discount is available.
    • Obtain data from Provider
    • Enter Information into PractiSynergy’s Credentialing Software
    • Populate and Send Payer Applications
    • Complete and Send Hospital Privilege Documents
    • Monitor Applications and Provide Updates to Provider
    • Forward Welcome Letters and Contracts to Provider as Received
    • Note Future Recredentialing Requirements
Existing Providers
  • Provide participation lists with effective dates
  • Maintain and update NPI and CAQH databases as necessary
  • Perform re-validation of applications and re-credentialing with payers 
  • Obtain and/or renew hospital privileges (if applicable)
  • Add new provider to new networks as they come into the market

On-Going Credentialing Maintenance CAQH and Recredentialing

$ 99 Monthly per provider (after initial credentialing is complete)
  • Maintain credentialing files with payers
  • Update locations, names, Medical Malpractice, license information​
  • Ensure recredentialing occurs on-time to eliminate disruption​
  • EFT (Direct Deposit) requests managed for all insurance companies​
  • Perform CAQH and Availity attestation quarterly​
  • Maintain payer directories (per Medicare guidelines)​

New-Provider Initial Credentialing Or Linkage to new Tax ID​

$ 199 Monthly x 12​
  • Bi-weekly status reports​
  • Where applications have been sent (around 12 payers included)​
  • Tracking number, phone number or email for each application​
  • Summary of the Status (if additional information was requested, contract being drafted, in medical panel for review, etc.)​
  • Team member responsible for updates and their contact information​

UNLIMITED Initial Credentialing/Linkage AND Credentialing Maintenance​

$ 299 Monthly per new provider​
  • All services listed prior​
  • No restrictions on the number of applications or insurance linkages​
  • All maintenance and recredentialing included​