Operations & Revenue

Healthcare Provider Enrollment

Becoming a health plan network provider is a time-consuming, but critical component of the revenue cycle. Providers need to bill for and be reimbursed for the services they provide to their patients. If your organization does it periodically, it can be an extraordinarily complicated process with fractured lines of responsibility.

Hiring a third party to assume the task of provider enrollment ensures that your providers are enrolled more quickly by dedicated staff. Even if you have an internal process to do this, it may make sense to hire an outside party so they can help if your team gets sick, leaves, or is inundated with applications. The most efficient companies have an automated system that can populate hundreds of different insurance carrier applications.

Use of workflows allows for accurate and complete submissions with continuous follow up to expedite approvals. Re-enrollment applications and provider documents should be updated continuously. Periodic status reports from submission through approval should be provided on a regular basis. Research can also be available to investigate the status of any pending enrollments prior to using services to determine what needs to occur to accelerate those health plan approvals.

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Preferred Partner

Credentialing physicians and other practitioners, and then enrolling them with Medicare, Medicaid, and commercial payers, can be time-consuming, complicated and costly to your facility.

With web-based software that allows for a completely paperless process, Hospital Services Corporation delivers industry-leading turnaround times for credentialing and enrollment. Hospital Services Corporation has been certified as a credentials verification organization by NCQA continuously since 1997.

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Erika Campos
(505) 343-0070
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Sally Lanilus
Position, Organization
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