Credentialing

and Enrollment

Completing the mountains of paperwork required for credentialing and enrollment, correctly and on time, is the backbone of financially successful physician practices.

 

Providers must obtain facility privileges and enroll with commercial payers and government insurance programs in order to receive enhanced patient referrals and maintain consistent cash flow.

 

Practicefirst’s comprehensive, electronic credentialing and enrollment system

  • Warehouses

  • Tracks progress

  • Identifies problems

  • Anticipates deadlines

Learn more about Practicefirst services:

Attention and Oversight

A typical credentialing application will ask for over 150 data points, requiring hours to gather and verify. Omitting or making mistakes when entering any of this data leads to delays and can be grounds for a denial.

 

Insurance providers, the government and healthcare systems are backlogged with credentialing applications. Practicefirst’s tracking system ensures documented delivery, receipt and that regular follow-up continues until the application is approved and participation is secured.

Ahead of CAQH 

CAQH profiles are your key to getting paid. They must be re-attested, updated and the credentialing contacts kept current.

 

We’re proactive when receiving an updated insurance, license or DEA document and upload it to CAQH with an updated expiration date. Our process ensures that reaccreditation delays are avoided. No one does is it better than Practicefirst.

Meet Our Expert

Amy Wilcox, Credentialing Manager for Practicefirst since 2013, ensures the credentialing process remains current, accurate and timely.

Effective credentialing is an exact science requiring attention to detail, meeting deadlines and constant oversight.  Ms. Wilcox provides leadership for process improvement and redesign to reduce costs, improve client satisfaction and meet client objectives.  She is vigilant about keeping current with industry and regulatory changes, and sharing that knowledge with clients.

- Dr. Helen Suchanick, C&S Medical

“Practicefirst not only handles my billing, but they have helped me get credentialed with new carriers, set up EDI agreements with all carriers, designed and provided superbills for the office, and answered coding and business questions.”

275 Northpointe Pkwy, Suite 50

Amherst, NY 14228

866.234.5017 (Toll-free)

info@pracfirst.com

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