Credentialing

Credentialing by qualified professionals

Credentialing is the gateway to any successful practice. Credentialing is no longer a part-time assignment but a critical and time-consuming component requiring the full-time attention of a qualified professional. Our credentialing team will validate documents, connect with insurance carriers and maintain compliance with all government and regulatory requirements. FPS recognizes the importance of maintaining an accurate and current credentialing profile for your practice. Our goal is to complete the application process promptly and with minimal disruption to you and your staff. Be sure to also look at our pages on Revenue Cycle Management and Practice Management.

Credentialing

FPS will provide a detail listing of all documents needed to facilitate a completed application. We will review your CAQH profile to ensure all required documents are current and valid. In the event that a provider does not have a CAQH profile, one will be created. All applications are carefully reviewed for accuracy prior to submission.

Our team will follow up to ensure that all applications have been received and are in process. A detailed file is maintained, which includes the current status for all carriers both pending and finalized.

Credentialing

Credentialing Services Include:

  • Individual provider enrollment.
  • Group enrollment.
  • Council for Affordable Quality Healthcare (CAQH) – enrollment and updates.
  • Verification and validation of current plans.
  • PECOS/Medicare updating and revalidations.
  • Maintenance of professional certificates, including medical license, malpractice insurance, and DEA registration.
  • Track expiring documents.
  • Monitor the status of pending applications.
  • Maintain a detailed database with payor updates.