STEP 1 : WE MEET

• Together we determine the overall goals of your providers, clinic, hospital or health system.

• Gather a list of all payers for which you participate (or want to participate).

• Discuss and agree on realistic deadline, billing start dates and when to hold claims (if applicable).

• We'll give you a quick overview on all the data and documents we'll need and how we'll gather it.

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STEP 2 : DATA AND DOCUMENT COLLECTION​

• The Project Management Portal is established and shared with the Practice Administrator.

• We'll collect all required data and documents (mostly through the Portal) with the help of the Practice Administrator.

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STEP 3 : CMS & CAQH ENROLLMENT / UPDATES

• We go to work on NPPES and CAQH updates. This is the baseline                                                     of Provider Enrollment as nearly all payers utilize these platforms.

• Medicare and Medicaid enrollment comes next.

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STEP 4 : COMMERCIAL ENROLLMENT & CONTRACTING

• Commercial enrollment and contracting comes next.

• IMPORTANT: Commercial plans do NOT back date!

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STEP 5 : MORE UPDATES & MCO

• Once Medicare and Medicaid are approved, CAQH is updated with relavent payer information.

• Enrollment with MCO(s) begin.

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STEP 6 : FOLLOW UP & MAINTENANCE KICK-OFF

• As payers process applications and approvals are received, we keep the Portal updated with all important communication and documents. We will also assign tasks to the Practice Administrator as necessary.

• You sit back while we make sure everything stays current!

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