Medical Credentialing & Enrollment Services
$ 150.00 fee Per carrier (Only billed to you once approved):
● Healthcare administration consulting services to help you decide which panels to join in your area.
● Provider enrollment services for physicians and healthcare entities (non-participating and participating with health plans)
● Credential verification for physicians and ancillary healthcare providers
● Regularly follow-up and tracking status
● Network management for health plans
● Managed care contracting Medicare provider enrollment and revalidation services
Prior Authorization for treatment & Verification of Benefits
$25.00 per case fee, this fee includes:
● Verifying patient benefits for the services you will render (deductibles, co-insurance, etc).
● Verifying service is valid & billable as some codes are excluded or expired.
● Submitting authorization or pre-determination if required.
● Obtaining exceptions when available (only applies to out of network providers).
● If any of the above mentioned is denied, we will submit an appeal at no additional charge.
● There is NO CHARGE for any denied, not approved, non-covered cases.
Claims
This pricing includes:
● Verifying the coding on the claim is correct.
● Submitting the claim
● Submitting clinics when/if required.
● Following up on the claim status.
● Appeals if necessary.
● We Do NOT Charge to file a claim to the insurance carrier
● Once a claim has been paid we only then invoice our providers 10%. This is based on the Actual check amount issued by the insurance carrier to your office or the patient. We do not invoice on the allowed amount, or applied to the deductible amount.