Provider Enrollment
Managed program eligibility, timely re-credentialing, and compliance that ensures revenue integrity.
Provider enrollment is the process by which healthcare providers apply to participate in various healthcare programs, such as Medicare, Medicaid, or private insurance networks and obtain privileges at a hospital or facility. The enrollment process typically involves submitting an application and providing documentation of the provider’s credentials, such as their medical license, certifications, and professional experience.
Welter Healthcare Partners will manage and streamline your practice’s provider enrollment.
Why is Enrollment Important?
The purpose of provider enrollment is to ensure that only qualified and reputable providers are allowed to participate with payers and obtain facility privileges to provide services for patients. Providers who are enrolled are typically required to adhere to certain standards of care and follow specific rules and regulations governing their participation in the program.
Once a provider is enrolled, they can receive payments for services rendered to patients who are covered by the program. Provider enrollment is an ongoing process, and providers must maintain their enrollment status by meeting certain requirements, such as completing continuing education courses or undergoing periodic credentialing reviews.
Provider Enrollment is time consuming and tedious – let us handle it for you!
Welter’s Role In Provider Enrollment
With a team of highly skilled credentialing and enrollment specialists, we recognize the criticality of submitting precise payer enrollment and hospital/facility privileging applications in a timely manner. We understand the significance of consistent follow-up throughout the enrollment process to ensure efficient processing of the provider’s file.
Our services are centered around providing a personalized approach to credentialing and prioritizing relationship-building with clients, payers, and facilities. Our expert team of specialists is dedicated to delivering the desired outcomes you seek, allowing you to focus on providing exceptional patient care.
Ongoing Credentialing Management Services
In today’s complex healthcare environment, maintaining and completing credentialing information for providers can be extremely cumbersome for practice managers and staff.
Improper credentialing management will create a domino effect of negative actions, including disruptions in your revenue, cash flow, and patient care.
Whether it’s for payers or facility privileges, we provide complete credentialing management services. Outsourcing your credentialing needs will help ensure your organization’s revenue integrity.
Credentialing Management Services
- Provider roster updates
- Completion of initial credentialing for new providers joining your organization
- Medicare enrollment and revalidations. Monthly tracking of upcoming revalidations.
- Medicaid enrollment and revalidations. Monthly tracking of upcoming revalidations.
- Completion of re-credentialing applications from payers
- Provider CAQH attestations
- Payer directory updates
- Initial hospital/facility appointments and reappointments
- Assistance with claims denials due to credentialing issues
- Confidential electronic storage of required credentialing documents (state license, DEA, CEU’s curriculum vitae, malpractice, certifications, etc.)
- Tracking of provider licenses and expireables
- Real time reporting and updates
“Our doctors spend more time caring for our patients”
Surgical Specialists of Colorado and Colorado Trauma Services has partnered with Welter Healthcare Partners since 2014. Welter Healthcare Partners knowledgeable staff in credentialing and payor contracting makes navigating our complex and ever-changing healthcare systems simpler for our group of 30 surgeons with multiple locations in Colorado. Their expertise helps our group maintain compliance and financial efficacy so our doctors can spend more time caring for our patients.
Melissa Fawcett
CEO
Surgical Specialists of Colorado, PLLC
Colorado Trauma Services, PLLC