Billing, Collection, Reporting of FeesIn-House ProgrammingContract NegotiationsConsulting ServicesUtilizations StudiesManaged Care Contractual ComplianceCertified Procedural CodersThird Party CredentialingBilling Compliance ProgramCapitation ArrangementsVirtual Private NetworkBlended Unit Payout
 

 

 

Our Credentialing Department provides the following services:

Establishment of provider numbers for new clients with Medicare, Medicaid, Medi-Cal, Blue Shield, Railroad Medicare, Cal OPTIMA, U.S. Department of Labor, and other payers as necessary

Establishment of provider contracts with Blue Cross & Blue Shield
Determination of billing requirements for “atypical” situations
Tax Identification verification and billing address updates
Maintenance of contract files
Maintenance of client account information
Maintenance of client credentials and issuance of documents as requested by facilities and insurance companies
Enrollment for electronic billing

We currently utilize the following websites:

 

AMERICAN BOARD OF MEDICAL SPECIALTIES UPIN DIRETORY
AIM DOCFINDER
CENTERS FOR MEDICARE AND MEDICAID (CMS) NATIONAL PRACTIONER DATA BANK CA BOARD OF REGISTERED NURSING NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM
(NPI Enrollment)
AMERICAN BOARD OF ANESTHESIOLOGY
EDUCATION COMMISSION FOR FOREIGN MEDICAL GRADUATES

CAQH UNIVERSAL CREDENTIALING DATASOURCE

CALIFORNIA DEPARTMENT OF HEALTH SERVICES

STATE MEDICAL BOARDS



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