Credentials Administrative Services is a full-service enrollment and credentialing company. Many companies rely on software and technology to handle their needs believing that it is working to its full capacity, but could it be better? We understand that every client's needs are distinct, and we work diligently to accommodate those needs. Software is only as good as the people running it, and implementing a software solution does not change the amount of resources an entity has available to handle a job. It is often used as a “band-aid” to the larger issue of the fact that there is no way to do the job effectively unless you have people who can follow up and do the leg-work as needed for each unique circumstance. This is how we differentiate ourselves from our competition.
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. Our expert team provides 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.