Anders Health Care uses our unique payor matrix to manage each step of the provider onboarding and enrollment process. We offer a seamless provider onboarding solution, meaning new medical provider hires can quickly get to work and accept payments. Our provider enrollment services are tailored to meet your needs to ensure that your health plan or government payer enrollments are completed, renewed or revalidated, and maintained in a timely and efficient manner. Our advisors can complete the following processes to alleviate the burden on organizations who lack the resources to complete them in-house:
- Data and document gathering
- PECOS and NPPES accuracy
- CAQH profile (initial or re-attestation)
- State Medicaid
- Managed Care Organization (MCO) universal rosters
- Provider directory, attestations (i.e. Availity, LexisNexis, etc.)
- Roster reconciliations
- ACH/EFT setup
- EDI setup
- Direct Data Entry (DDE)
- Completion and submission of applications
- Follow-up and follow-through until provider participation are received
- Provide our clients with continuous communication via emails and standing meetings
Maintenance
Overlooked expiration dates on important documents like certifications, CME, malpractice insurance and others can create costly delays in the provider enrollment and credentialing process. Anders advisors can help prevent negative impacts to the revenue cycle through managing expiring data and documents. Using automated alerts, Anders ensures providers remain compliant with payer regulations and never become inactive..
- CAQH profile re-attestations
- Change of information and updates
- Electronic Data Interchange (EDI) updates
- Managed Care Organization (MCO) universal rosters
- Medicare and Medicaid revalidations
- Out-of-state Medicaid revalidations
- Commercial payer renewals
- Direct Data Entry (DDE) updates
- Denials management (related to enrollment issues)
- Provider directory, attestations (i.e., Availity, LexisNexis, etc.)
- Provider data management
- Term facility/provider with payers
- Third-party liability forms
- Acting as a liaison between client, providers, payers and hospital credentialing entities
- Roster reconciliations
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