Credentialing and Staff Appointment:
• New provider information sheet set-up
• Practitioner demographic data
• Verification of credentials
• Appointment application process
• File review and staff appointment
• Appointment approval letter forwarded to Client
Health Plan Enrollment and Linkage:
• NPI and provider numbers obtained as necessary
• Enrollment and linkage applications completed and reviewed
• Cover letter generated
• Applications, cover letter, and all required attachments dispatched to insurers and tracked appropriately
• Follow-up initiated with each plan weekly until enrollment completed
• Notification of Client upon completion
Optional Credentialing Contract Maintenance:
• Maintaining active in-network status as a participating provider with all selected insurances
• Re-attestation of CAQH applications every 120 days, upon provider approval
• Completion of re-credentialing applications for unlimited number of carriers throughout the year, via phone, fax, mail and email requests, including Medicare/Medicaid revalidations.
• Working with Client staff on credentialing-related claims issues and problem resolution
**These services are delivered by SBSC, a trusted business partner and contractor independent of NNPEN. Contact us for an introduction to the SBSC team serving NNPEN members, including their pricing of services for NNPEN members.
SBSC was founded by Nancy Nager, a psychiatric nurse whose outreach practice provided care for medical and behavioral health patients. She felt that there was something missing: specialists that understood the reimbursement requirements for a psychiatry practice. She needed a company that knew the nuances of medical and mental health care and that could be available every step of the way.
With a 28+ year track record in medical and behavioral health revenue cycle management, her team has been there before and knows how to get you paid, guaranteed.
They also know how to get you credentialed and offer those services to NNPEN NPs on an unbundled basis. https://sbscincorporated.com/services.html#sec1