Provider Enrollment & Credentialing Services
Refine your healthcare management by preventing delays in claim submissions, late filings, and revenue loss with our professional credentialing services. At Maaz informatics, our expert team manages provider enrollment and credentialing process, ensuring that your physicians are properly credentialed and enrolled. Trust us to manage the complexities of MD Credentialing so you can focus on delivering quality care.
Maaz informatics offers comprehensive Provider Enrollment and Credentialing Services designed to reduce your on-hold claim values, standardize administrative processes, and save time while ensuring compliance. For more information, please contact us: info@maazinformatics.org
Our Medical Credentialing Services Include
Credentialing & Re-credentialing
We obtain eligibility verification from insurance companies before the patient’s appointment. This process ensures that there are no insurance denials.
Dedicated Team
A team that completes credentialing details and submits them to commercial insurers, Medicare, and Medicaid as requested by healthcare physicians.
Compliance
Maaz informatics’ MD credentialing services ensure compliance with the national committee for quality assurance (NCQA) and the department of health and family services (DHFS).
Critical Follow Ups
Our medical billing and credentialing services ensure that all follow-ups are performed properly for a smooth enrollment.
Portal Registrations
Create and update CAHQ, PECOS, & MILMIC credentialing portals.
Contracting Issues & Data Integrity
We resolve contracting issues and maintain data integrity by conducting audits.
PROVIDER CREDENTIALING
The process involves the following steps:
- Application Evaluation: Completing required documentation and identifying exceptions.
- Primary Source Verification: Verifying practitioner/ facility information directly from physicians.
- Outbound Call Center: Obtaining missing documents and updating the payer’s database.
- Follow-up with Payers: Following up on submitted credentialing requests.
- Data Entry: Capturing data, labeling, and linking images to specific providers/ facilities in the payer’s database.
- Maintenance of Provider Data: Updating provider information according to policies and procedures, including the CAHQ profile.
PROVIDER ENROLLMENT
The process involves the following steps:
- Verification of Provider Information: Contacting payers to ensure they have the correct provider information on file before claims are submitted.
- Updating Practice’s Pay-To Address: Validating and updating the provider’s pay-to or billing address.
- Monitoring process: A highly skilled team performs research and analysis to identify potential process or functionality gaps.
- Enrollment for Electronic Transactions: Our team enrolls providers for various types of electronic transactions.