Every change application is a chance to prevent fraud.
With the ever-present threat of fraud, the ongoing maintenance of your provider network is critical. So we’ve created a consistent, proactive process that won’t slow down healthcare delivery or keep plans members out of physician offices.
Approvals or denials are the result of fast, electronic workflow systems, applicable credentialing and verification, and a thorough credentialing council review. In cases of recalcitrant providers or aberrant billing practices, there is an immediate recommendation to revoke billing privileges and carefully document revocation process. For providers with a 12-month lapse in billing, privileges will be deactivated.
Consistent credentialing and maintenance practices help you maintain the highest level of efficiency and effectiveness. Earn the twin benefits of administrative savings and time to focus on delivering high quality healthcare.