Credentialing Management and Maintenance
Enjoy peace of mind knowing your provider's profiles are taken care of
PayrHealth can ensure all of your providers are appropriately credentialed, their profiles are up to date, and they can continue to be reimbursed - minimizing disruptions in your revenue streams.
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We provide a proven process so you can focus on excellence in patient care.
Re-Attest CAQH on Schedule
Contracted healthcare providers are required to re-attest the information on their online CAQH profile every 120 days. Sticking to this schedule can be challenging, especially for large healthcare organizations with limited time and resources.
Update CAQH As Needed
Your CAQH profile must remain current when working with commercial insurance companies. We'll update your information anytime and alert you when any items are about to expire.
Manage Payor Contract Renewals
Most payor contracts remain active for one to three years. Failing to re-contract with a payor can result in your healthcare organization being disenrolled from the network.
Ongoing Support
As a valued PayrHealth customer, our team can provide guidance and advice when you need it. We can also be a liaison and advocate between you and your payors.
How to Stay Up-to-Date on the Credentialing Process
Re-credentialing is a lengthy and time-intensive process. To maintain your physician credentials and insurance reimbursement privileges, you'll need to follow these steps:
Re-Attest Your CAQH Profile Every 3 Months
Providers working with insurance companies need to attest their information every 120 days. Any delays in this process can result in rejected claims.
Update CAQH Profile on Each Demographic Update
Any change in a provider's demographics needs to be updated in their CAQH profile. The CAQH is home to huge datasets, and it can be difficult to maintain without regular review and updates.
PayrHealth works within many different industries:
- Physicians
- PAs/ NPs
- PT/OT/SLP
- Podiatrists (DPM)
- Chiropractors (DC)
- Optometrists
- Audiologists
- Behavioral Health Providers
- Hospitals
- and More
When working with PayrHealth, you’ll get the following 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 your billing office 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+
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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 PayrHealthSuccess stories from our providers that partner with PayrHealth
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Some questions and answers
Hospitals and large practices must re-credential every three years. Physicians and providers, on the other hand, must re-credential every 120 days. For healthcare professionals especially, this can be a tight deadline.
Failing to re-credential on schedule can cost you money, time, and a headache.
If you continue to treat patients past the timeframe of your agreement, you can be penalized or even kicked out of particular insurance networks.
It's possible to lose reimbursements in the event of claim denials when you don't re-credential on time
