Initially Pediatrics, grew into a multi-specialty practice
Medical Group in Minnesota
20
Days Faster than the national average.
Since 2013
Payrhealth has been assisting this provider group with credentialing services
Credentialing
Expert Healthcare Credentialing & Payor Enrollment
Creating a new practice, changing practice locations, adding a new provider, or breaking away from a group all require new enrollment and provider credentialing services. Your primary goal is to focus on your patients, and PayrHealth can offer dedicated, expert healthcare credentialing services to help with medical enrollment and the credentialing process.
Free Consultation
We provide a proven process so you can focus on excellence in patient care.
Commercial Enrollment
- Commercial Insurance Provider Enrollment & Credentialing (Anthem BCBS, Aetna, Cigna, United Healthcare, and any other plan available in geographic area)
- Can complete both initial and recredentialing applications
Medicare & Medicade Enrollment
- Initial applications for both groups and providers
- Reassignment of benefits & group application updates (ownership, location, etc.)
- Revalidations for both groups and providers
Medical Credentialing Management & Monitoring
- Ongoing CAQH profile maintenance (Reattestations as required by health plans)
- Ongoing health care portal maintenance (Availity, One Health Port, etc.)
- Ongoing support- PayrHealth will provide you with general guidance and advice as you navigate payor relationships
- Access to our provider data management system which will house all of your providers’ information in one place
Primary Source Verification
- Initial verification of provider information as outlined by NCQA standards.
- Monthly monitoring of OIG/SAMs databases
- Recredentialing available on a 2 or 3 year cycle based on your preference
Hospital Privileging
- Initial and recredentialing application support
- Access to our provider data management system which will store credentialing dates and recredentialing dates so you don’t have to worry about missing a deadline
Medical Licensing Services
- Initial license applications
- Assistance with license renewal applications
- CME tracking available within our provider data management system
What PayrHealth can deliver to your credentialing process
Time-consuming, tedious tasks like enrollment applications are critical to ensuring you’re paid what you’re owed for providing health care. Our team of industry veterans can help alleviate the following headaches:
Turnaround time
Improve the turnaround time of your enrollment applications and healthcare credentialing process.
Resources and Capacity
Find a dedicated team to work on physician credentialing with all insurance networks.
Staff and Talent
Get support from experienced healthcare industry experts who advocate with insurance networks to remove paperwork burdens from your practice.
Measurable Progress
Our PayrHealth portal provides real-time access to your healthcare credentialing applications' files, information, and status.
PayrHealth works within many different industries:
- Primary Care and Specialist Physicians
- Solo practice
- Group practice
- Multi-specialty practice - Behavioral Health Providers
- PT/OT/SLP
- Hospitals
- ASC's
- Integrated Delivery Systems
- IPA/PHO
- MSO
- ACO
- DME
PayrHealth offers the following services and more:
- An assigned healthcare provider enrollment coordinator to advocate with insurance networks
- Support staff to ensure your files and credentialing information are kept current
- Access to our PayrHealth system where you and your staff can monitor the status of healthcare credentialing, retrieve information, and store files, keeping your credentialing and enrollment data in one central, secured location
- Paperless intake with the cloud-based PayrHealth Cred System, keeping setup time minimal
- Credentialing applications completed and submitted - including all necessary information and documents - to your chosen payor networks
- Regular maintenance of your CAQH profile
- Follow up with all payors after completion to ensure that your contract is loaded and you're ready to bill as an in-network provider
- Maintenance of all contracts in the PayrHealth Cred System for convenient access and monitoring
- Close collaboration with you and your staff to provide timely information on your effective dates for billing
We integrate as a department of your practice
- We integrate as a department of your practice. We learn your practice inside and out, working based on your unique goals and needs. The process of credentialing requires deep knowledge and expertise, meaning we bring valuable skills to your team that you won't find elsewhere.
- We enhance performance. With medical credentialing experts working solely on the credentialing process, you can get more effective and efficient results. PayrHealth can allow your team to focus on other things, helping your practice meet goals and strengthen day-to-day operations.
- We improve patient relationships. When your team doesn't need to focus on paperwork, they can focus on the patient experience instead. Your team can grow connections and expand your reach, setting your practice up for success.
- We increase revenue. Consistency is key to generating revenue, and medical credentialing can be costly to your time and resources. Fast, efficient enrollment means your healthcare providers can see patients, retrieve reimbursement, and collect on services without interruption.
- We reduce risk. In the healthcare industry, regulations and requirements change constantly. Our expert team remains up-to-date to ensure accuracy and compliance, minimizing errors that could interrupt your revenue streams.
30+
years in business
50
States Experience
100,000+
Enrollment applications submitted
20,000+
CAQH profile reattestations per year
By the numbers with PayrHealth
Our success is recognized across the healthcare industry. Hear from real organizations and healthcare providers of all sizes to learn how we made substantial changes to their practice revenue – and how specifically we can help you.
About PayrHealthFrequently Asked Questions
Some questions and answers
What is your turn around time?
Turnaround times vary by insurance plan. Most major commercial carriers can complete the credentialing and contracting process in 90 – 120 days. Less efficient carriers often take longer than 120 days. Most Medicare contractors are completing provider applications in 60 – 90 days. While we can’t control how long an insurance company takes to process your application, we follow up on all your applications on a regular basis to ensure the process is progressing.
How can I track my progress?
You have real-time access to our cloud based software platform to monitor the progress of all your credentialing applications. You can also run reports, retrieve documents, update your information, and maintain your CME history using our software platform.
What kind of clients do you work with?
We work with physicians and other healthcare providers in all medical specialties and most behavior health specialties ranging in size from solo practitioner clinics to large health system owned medical groups.
How do I get started?
Fill out our free consultation form here. Each client is a unique and we customize a service proposal to fit your exact needs.
Hospital privileging vs credentialing?
- Hospital privileges and hospital credentialing sound similar, but they are indeed two different processes. Hospital credentialing must happen before you apply for hospital privileges.
- During this credentialing process, the medical facility will focus on ensuring that you are able to provide competent and safe patient care. To do so, hospital bylaws will be consulted and you will be required to provide proof of your education and medical training.
- If you are credentialed, you will be able to request hospital privileges. If you are found unworthy of being credentialed, you will not be allowed to practice at that facility.
- PayrHealth can help with both privileging and credentialing.
What is Primary Source Verification?
Primary Source Verification refers to verifying a health care provider (Typically MDs, DOs, NPs, PAs etc.) credentials such as education, training, certification, licensure etc. with the Primary source to determine the accuracy and authenticity. Primary source verification generally includes a combination of online verification with the direct source, telephone confirmation and other direct correspondence.
What is the difference between Credentialing & Primary Source Verification?
Credentialing typically refers to insurance credentialing / medical credentialing i.e getting on insurance panels with insurance companies so that you can bill as in-network. Primary Source Verification (Sometimes referred as Primary Source credentialing) is verification of provider credentials directly with primary source.
