Practice Development | Practice Management | Practice Valuation | Credentialing | Provider Panels | Billing and Collections

Credentialing

Credentialing and Contracting Services

Simply put, use a professional credentialing organization to get you and your doctors into managed care provider panels, as an actively participating member. Our organization has been credentialing for over 25 years. We are familiar with the procedures and complex protocols involved in credentialing and contracting with managed care organizations. Conducting an audit of your existing contracts will indicate the panels you are missing. Creating Letters of Interest on your behalf, getting the panel open again for your speciaHy, assuring the managed care staff that applications will be prepared properly, reviewed, signed, with all appropriate credentials attached we assume full responsibility for the entire process. We credential daily for over 300 doctors and related medical specialists located throughout Nevada And we get them the contracts they need quickly and efficiently by auditing each week the progress of their applications. We never give up until we succeed in getting an applicant on a provider panel.

Need Managed Care Contracts Credentialed or Re-Credentialed?

Call us at (702) 364-2044 or e-mail tulles2000@aol.com. Our staff prepares credentialing and contracting applications for doctors and related medical professionals, diagnostic and surgery centers, and other organizations. We have over 25 years of experience in dealing with the complexities and politics of contracting with managed care organizations: Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), Workman's Comp Organizations (MCOs), and all the second and third tiers of provider panels: EPO (Exclusive Provider Organizations), POS (Point of Service Organizations), and even IPAs (Independent Practice Associations). We also prepare hospital and surgery center recredentialing.

Do you realize that over 200 managed care organizations now serve employers in Nevada? We may have only 8 HMOs, but we have also over 220 companies approved to provide workman's compensation medical coverage. And don't forget: the majority of Nevada's large employers (100 employees or larger) are "self-insured", which means that they have been approved by the Nevada Department of Insurance as independent, licensed, insurance organizations. As of 1/1/2002, over 832 employers in Nevada are self-insured, and the majority must rent a provider panel, usually "customized" to suit their particular needs. Customizing, of course, means simply that an employer may want a particular doctor, clinic, diagnostic facility, etc., in their provider panel, and the PPO will then "open up" their provider panel to include the employer's selection. Without exception, the employer is boss. If the employer wants you or your clinic, you'll get accepted into the panel with our credentialing.

Nevada, although a state where both union and non-union workers coexist remarkably well, now hosts over 68 union organizations, all of which must maintain or rent a provider panel that is usually "customized" to their choice of panel participants.

Want to get you or your doctors credentialed into existing or new managed care provider panels? Do you need recredentialing constantly for your doctor of medical group?