Proper credentialing and payer contracting are essential for healthcare providers to establish trust, ensure compliance, and receive reimbursements from insurance companies. At MediCharge Billing LLC, we offer comprehensive credentialing and contracting services to help providers navigate the complex process of enrolling with payers, negotiating contracts, and maintaining compliance with industry regulations. Our expertise ensures that healthcare professionals can focus on patient care while we handle the administrative burden.
Provider Credentialing Services
Initial Provider Enrollment & Credentialing
We assist individual providers, group practices, and healthcare organizations with enrolling in insurance networks and obtaining the necessary credentials. Our team ensures that all required documentation, including licenses, certifications, and malpractice insurance, is submitted accurately and promptly.
CAQH Profile Setup & Maintenance
Many payers require providers to be registered with the Council for Affordable Quality Healthcare (CAQH). We help with setting up and maintaining CAQH profiles, ensuring that all information is up to date and compliant with payer requirements.
Re-Credentialing & Ongoing Compliance
Insurance providers require periodic re-credentialing to ensure providers meet quality standards. We monitor re-credentialing deadlines and handle all renewal paperwork, keeping providers compliant and avoiding service disruptions.
NPI & Tax ID Registration
We assist with obtaining or updating National Provider Identifier (NPI) numbers and ensuring that Tax ID details are correctly linked with insurance payers for seamless claims processing.
Payer Contracting & Negotiation Services
Insurance Contract Negotiation & Enrollment
Our team helps providers secure favorable contracts with commercial and government payers by negotiating reimbursement rates, terms, and conditions. We ensure that providers receive competitive reimbursements for their services while complying with payer policies.
Medicare & Medicaid Enrollment
We assist providers in enrolling with Medicare, Medicaid, and other government-sponsored healthcare programs, ensuring compliance with federal and state requirements. Our team handles the submission process and follows up to ensure timely approval.
Payer Fee Schedule Review & Compliance
Understanding fee schedules is crucial for maximizing revenue. We review payer reimbursement rates to ensure that providers receive fair payments for their services. Our team also ensures compliance with payer-specific billing policies.
Contract Management & Updates
We track contract renewal dates, amendments, and updates, ensuring that providers remain compliant with evolving payer requirements. Our team also helps renegotiate contracts when necessary to optimize reimbursement rates.