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Streamlined processes, accelerated approval timelines, and regular compliance are critical, from providers to specialists and everyone involved in patient care. With the trusted support of Alpha Core Healthcare, we can provide you the advantage of having best in class enrollment and credentialing services. Our team will do all the work on your behalf accurately and efficiently so you can spend more time with your patients, and less time with administration. For more info visit :https://alphacorehealthcare.com/credentialing-enrollments
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Unlocking Efficiency: Best Practices in Provider Enrollment & Credentialing Healthcare faces a significant administrative challenge in provider enrollment and credentialing. These essential processes are crucial for compliance, patient safety, and robust revenue cycles. Delays in these areas can cost practices an average of $30,000 per provider monthly.
The Credentialing Complexity: Navigating the Maze Lengthy Timelines 1 Average 90-120 days for a full credentialing cycle. High Error Rates 2 Manual processes lead to 15-20% data discrepancies. Resource Intensive 3 Requires 80-100 hours of administrative work per provider. Revenue Delays 4 Direct impact on patient access and claims submission. Regulatory Scrutiny 5 Adherence to NCQA, Joint Commission, CMS standards.
Streamlined Provider Enrollment: Accelerating Time- to-Revenue Faster Payer Contracting: Reduces 60-90 day wait times significantly. Optimized Applications: Ensures 95%+ first-pass acceptance rates. Reduced Denials: Minimizes claims rejections due to non-credentialed status. Enhanced Provider Experience: Frees up clinician time for patient care.
Core Service Components: A Comprehensive Approach Primary Source Verification (PSV) Application Management Network Enrollment Verifies licenses and certifications directly from their original source. Completion and submission of applications to over 500 payers. Adds providers to commercial, Medicare, and Medicaid plans efficiently. Re-credentialing Ongoing Monitoring Proactive management of expiring credentials every 2-3 years to ensure continuous compliance. Continuous checks for sanctions and exclusions (e.g., OIG, SAM) to maintain integrity.
Leveraging Technology for Superior Outcomes Automated Workflows Reduces manual tasks by up to 70%, boosting operational efficiency. Secure Digital Portals Centralized document management and tracking for enhanced security and accessibility. Real-time Analytics Provides instant visibility into credentialing status and performance metrics. AI-Powered Data Validation Identifies inconsistencies and errors three times faster than manual review. Integrated APIs Seamless connection with EHR and practice management systems for a cohesive workflow.
Ensuring Compliance and Mitigating Risk Regulatory Adherence: Meets strict NCQA, URAC, and Joint Commission guidelines. Audit Readiness: Maintains pristine, auditable documentation records for seamless audits. Fraud Prevention: Screens providers against federal exclusion lists to prevent fraudulent activity. Patient Safety: Verifies provider qualifications and conducts thorough background checks. Malpractice Insurance: Ensures active coverage and reviews claims history to mitigate risks.
Your Partner in Excellence Alpha Core Healthcare We specialize in provide best enrollment and credentialing Services. Trusted by over 300 healthcare organizations across 40 states, our dedicated team ensures an impressive 99.8% compliance success rate, empowering your practice for sustained growth and operational excellence.
