Our network management team has a proven track record in the development and management of provider data. Outsourcing network management is a cost-effective way to deal with new regulations requiring health plans to control administrative overhead. In addition to primary source verification, the credentialing process is central to the management of provider demographics, continuing education, sanctions, and can be the direct source for application for privileges, membership, or participation.
Primary Source Verification Application & Initial Credentialing
- Credentialing Application is a web-based link by client request.
- Upon receipt of the completed application, the client and provider receive a confirmation email and the primary source verification process begins.
- Completed file (PDF) uploaded to our client-specific web site includes a summary of all verified data, supporting reports (NPDB and AMA, etc.) and verification records.
Re-credentialing
- Re-credentialing Application link sent to provider 3-4 months prior to the expiration of the initial credentialing file.
- Upon receipt of the completed application, the client and provider receive a confirmation email and primary source verification of required elements begins.
- Completed file (PDF) uploaded to our client-specific web site includes a summary of all verified data, supporting reports (NPDB and AMA, etc.) and verification records.
Delegated Credentialing Oversight Audits
Healthcare entities who offer delegation of the credentialing process to networks, hospitals, or large provider groups must perform delegated credentialing oversight audits on a regular basis. Precision Credentialing Services performs these audits for our clients who offer delegation. Audits include policy review and electronic file review for initial and re-credentialed providers.
Dynamic Credentialing
- Monitor and obtain current records for expiring documents (license, liability insurance, DEA, etc.) between credentialing cycles.
- Client access to updated documents through our client-specific web site.
Overflow Credentialing
Manage credentialing work as needed in times of high application volume and staffing shortages by outsourcing only what you need, when you need.