Provider Enrollment & Credentialing

Whether you have a new physician joining the group or an established physician who has been with your practice for years, insurance companies require updating credentials on a regular basis. If updates are not addressed in a timely manner, claims can be denied, resulting in an interruption of cash flow.

Revenue Cycle Solutions Provider Enrollment & Credentialing

Challenge

Professionals responsible for the provider enrollment and credentialing processes know the tremendous amount of time, organization, and detail these tasks demand. If applications are not updated consistently and monitored, the organization can run into serious reimbursement issues. Depending on the number of physicians in your group, keeping up with all the provider credentialing requirements and paperwork can be overwhelming.

Our Services

Revenue Cycle Solutions’ Physician Services team features a unique blend of talented professionals who are experienced in the credentialing profession. We understand credentialing is a continuous, tedious process, and we customize our services based on your organizational needs. Some of our credentialing services include:

  • New provider enrollment (All Payers/Multiple States)

  • Commercial insurance credentialing (Aetna, Anthem, BCBS, Cigna, Tricare, Humana, United Healthcare, and others)

  • Medicare and Medicaid Provider Enrollment (including HMOs)

  • Recredentialing for established providers

  • PECOS/Identity and Access Management System updates

  • Professional license renewal

  • Preview (formerly CAQH) enrollment updates and new registration

  • Credentialing and enrollment for physicians assistants, nurse practitioners, and dental providers

  • Demographic or name changes

  • Group and individual Medicare revalidation

  • NPI Registration (Type I and Type II)

  • Facility privileging

  • Payer update requests for changes in demographic/provider information

  • Working closely with insurance payers in all 50 states

Our Approach

While prospective recruits may have the right resume to match the job, there are multiple factors that determine who is the best fit. RCS screens candidates to ensure they have the technical capabilities to perform the job and are compatible with your organizational culture.

Monitoring your vitals

What are the benefits?

Provider Credentialing

Benefits

Working with RCS’s Virtual Patient Account Management team provides:

  • An affordable alternative to skilled patient account manager

  • Continuity of management services

  • Ongoing monitoring of performance by an objective third party

  • Extra emphasis on achieving department cash goals

  • Identification of methods to improve reimbursements

  • Mentoring and education of key personnel

  • Benefits of outside consultants while maintaining operational control

Get a Quote

If you would like more information on our Provider Enrollment and Credentialing Services please contact us by sending your name email and phone number below.

Revenue Cycle Solutions Location Pittsburgh