Our payer credentialing services are an affordable way to ensure that your health plan / government provider enrollments and hospital privileges are completed, renewed, and maintained in a timely and efficient manner. We offer full payer credentialing services at a low, per month per provider fee. After initial collection of the standard credentialing documents, providers will need only submit periodic updates to their credentialing file. We offer a worry-free system that is nearly 100% electronic.

COMMERCIAL PAYER ENROLLMENT – PROVIDER/PROVIDER GROUP

This service is offered to ensure timely provider enrollment (initial credentialing) with your third-party commercial payers; and on-going recredentialing to ensure payment per your contracted fee schedule and highest benefit for your patients. After the initial enrollment, a monthly flat fee for on-going credentialing is an affordable way to ensure continued participation with these plans. Service includes the following:

• Completion and submission of WPA (or other payer specific applications)
• Completion and submission with any payer specific addendums
• Submission of required supporting documentation as requested by payer
• Follow up and follow through to approval
• Includes setup and maintenance of CAQH Credentialing Database for purposes of health plan credentialing and recredentialing

GOVERNMENT PAYER ENROLLMENT – PROVIDER/PROVIDER GROUP

This service is offered to ensure timely enrollment (initial credentialing) with your Government payers to include, Medicare, Medicaid, and Labor & Industries, etc to ensure reimbursement and highest benefit for your patients. After the initial enrollment, on-going credentialing monitoring is included in the monthly flat fee for Payer Credentialing Services. Service included the following:

• Completion and submission of government-specific applications via forms
• Maintenance of government credentialing enrollment database(s), i.e. PECOS, ProviderOne, NPPES
• Submission of required supporting documentation as required by payer
• Follow up and follow through to approval

HOSPITAL PRIVILEGING AND CREDENTIALING – PROVIDER/PROVIDER GROUP

PSCS will act as liaison between the provider and the hospital medical staff office for Initial Credentialing and Recredentialing of Medical Staff appointment and privileges. The service is billed at a per application fee or a per provider per month all credentialing inclusive fee and includes coordination of the following to the Medical Staff Office:

• Submission of Washington Practitioner Application (or hospital specific credentialing application) and supporting documentation
• Completion and submission of hospital-specific addendum and required forms
• Follow up and follow through on additional requests, clarifications to approval