Credentialing | PractiSynergy: Best Medical Billing & Consulting Company

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 (if applicable)
Monitor Applications and Provide Updates to Provider
Forward Welcome Letters and Contracts to Provider as Received
Note Future Recredentialing Requirements

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

Existing Providers

$ 149 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)

$ 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

$ 299 Monthly per new provider

All services listed prior
No restrictions on the number of applications or insurance linkages
All maintenance and recredentialing included

Best Value

Credentialing & Contracting

Insurance Credentialing Services

New Providers

Existing Providers

On-Going Credentialing Maintenance CAQH and Recredentialing

New-Provider Initial Credentialing Or Linkage to new Tax ID

UNLIMITED Initial Credentialing/Linkage AND Credentialing Maintenance

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