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  Getting the proper paperwork needed to submit applications.Monitoring the process to make sure the application is expedited by the managed care plans. Getting the right information to our Billing Teams to facilitate payment. Making sure you're getting paid in accordance with the agreements we establish. Credentialing doesn't end when the managed care plans approve a provider. Verifying a provider is credentialed and will get paid is one thing; ensuring they are paid the contracted rates is another. By performing audits on payments rendered by newly-credentialed providers, we've been able to identify when plans are paying the providers according to our contracted rates and when they're not. Identifying problems early on is critical. The sooner underpayments are identified, the sooner the plans can correct their systems and the fewer underpayments there will be. |
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