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)
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Maintain credentialing files with payers
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Update locations, names, Medical Malpractice, license information
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Ensure recredentialing occurs on-time to eliminate disruption
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EFT (Direct Deposit) requests managed for all insurance companies
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Perform CAQH and Availity attestation quarterly
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Maintain payer directories (per Medicare guidelines)
New-Provider Initial Credentialing Or Linkage to new Tax ID
$
199
Monthly x 12
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Bi-weekly status reports
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Where applications have been sent (around 12 payers included)
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Tracking number, phone number or email for each application
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Summary of the Status (if additional information was requested, contract being drafted, in medical panel for review, etc.)
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Team member responsible for updates and their contact information
UNLIMITED Initial Credentialing/Linkage AND Credentialing Maintenance
$
299
Monthly per new provider
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All services listed prior
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No restrictions on the number of applications or insurance linkages
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All maintenance and recredentialing included
