Credentialing
Provider Enrollment and Medical Credentialing Services are long and complicated processes where a provider’s experience and qualifications are reviewed for the purpose of enrolling them with government and commercial payors. EMS can provide a wide range of credentialing services to specifically suit your needs.
Our Step-by-Step Credentialing Process
a) After signing your new contract, our team with work with you to obtain all the necessary information/documentation to assure we have everything we need for a seamless transition, including review of your full payer list.
b) In addition to a comprehensive review of your current payers, your account manager will work with you to ensure we have everything needed to submit and process any new applications or complete any applications you may have had in process.
a) EMS will submit complete applications to the correct contacts, making sure to get everything done in a timely fashion. This includes sending LOI’s (Letters of Interest) in order to update a current contract or initiate a new contract.
b) As soon as we confirm your application has been approved, we will be sure to follow it through contracting.
a) During this process we will keep in close contact with all insurance companies and complete the application process.
b) Our follow-up process starts as soon as an LOI or application has been submitted and continues until everything has been finalized.
a) You’ll now start seeing agreements coming in. We’ll make sure to carefully review and approve these new contracts, if they don’t need to be negotiated. Obtaining counter-signatures and being loaded into the payers database can take anywhere from 30 to 60 additional days.
b) Lastly, we will again review your payer list and ensure we have effective dates and provider IDs for all applicable payers. You will receive a fee schedule with your finalized application. We will then work with you, or on your behalf, to provide this information to your billing company or department.