Our Mission Statement
Specializing in credentialing and payer enrollment, Credentials Administrative Services is dedicated to providing exceptional service to the healthcare community.
What We Do
Credentials Administrative Services works to create a seamless and organized approach to credentialing and payer enrollment so that our clients can breathe a little easier knowing they have a confidential and professional liaison that works tirelessly on their behalf to help them maintain and/or achieve accreditation standards and revenue goals.
We will work directly with your staff and the various Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), private payers, Medicare, Medicaid, and more in order to accomplish and follow through on your credentialing and / or provider enrollment needs.
Our continuous follow-up processes and exceptional communication with credentialing and payer enrollment allows our focus and loyalty to remain solidly with our clients to assist them in maintaining accreditation standards and revenue goals set by their organization in the ever-changing business of healthcare in the United States.
From hospital systems to sole proprietorships, we handle the enrollment process with Medicare, Medicaid, private insurance, MCOs, and more! This also includes managing delegated credentialing, confirming re-credentialing, and Medicare and Medicaid revalidations.
CMS mandates that payer directories be kept up-to-date to ensure patient access to healthcare. Our team maintains a database of your providers' demographic information at all times to ensure that this information is readily available when requested.
Primary source verification of healthcare providers' credentials before granting privileges is key to ensuring compliance with accreditation standards and minimizing risk for your organization. We provide a tailored credentialing process for each client, ensuring that your unique needs are met.
More than ever, commercial payers and healthcare networks rely on CAQH Proview™ for credentialing and recredentialing. An accurate record in CAQH Proview™ ensures that your provider's credentialing or re-credentialing application can be processed quickly and efficiently. We maintain and update this vital record on an as-needed basis to ensure that credentialing or re-credentialing is as smooth as possible.
Research and verification
Our expert team can quickly verify your providers' network status and discover any gaps where you may be losing revenue. This includes verification that data is listed accurately in payer directories, ensuring that patients can locate the right provider for their needs.
We offer administrative support services in multiple facets, such as claim denial research, creating and updating résumés / CVs, remote data entry, etc.