Provider Enrollment and Credentialing Services

• Initial and Re-Credentialing Applications submission to Managed Care Organizations
• Assist with obtaining NCQA and URAC Credentialing and Network Accreditations
• Credentialing Delegation/Vendor Management
• Creating Credentialing and Re-Credentialing policies
• Credentialing Committee processes

• Commercial Insurance Provider Enrollment: BCBSLA, Humana, United Healthcare, Cigna, etc
• Louisiana Medicaid Enrollment: Aetna, Healthy Blue, Louisiana Healthcare Connections, United HealthCare, AmeriHealth Caritas Louisiana
• Medicare Enrollment
• CAQH Registration: Initial Profile registration and continue quarterly   re-attestations

 
 Credentialing Delegation program
As health care systems grow larger more providers are being credentialed with Health Plan Organizations under what is known as Delegated Credentialing/Vendor Management.  This is a process where a health plan organization gives authorization to the provider group to perform credentialing in-house.  If your organization are looking into participating as Delegated Group with a Health Plan Organization, I can assist you with the complete process.  As a former Credentialing Manager, I created the credentialing delegation program for a large managed care organization and have the experience and knowledge of Delegation Credentialing/Vendor Management.

 NCQA and URAC Credentialing and Network Accreditation
 With experience working with National Committee for Quality Assurance (NCQA) and Utilization Review         
 Accreditation Commission (URAC) for over 20 years, I will bring my knowledge and best practice experience in the
 credentialing, re-credentialing, network management and quality improvements processes.
 
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