PAYER ENROLLMENT THROUGH GURU
PAYER ENROLLMENT AND CONTRACTING
Payer enrollment—also referred to as provider enrollment—is the act of enrolling providers with your health plan so they are considered “in-network,” or “participating.” It is the first step in the revenue cycle. Payer enrollment is part of credentialing.
Credentialing Guru’s Payer enrollment services help Behavioral Health practitioners, groups and facilities to unravel the complex process of credentialing providers and enrolling them in payer networks.
It’s important to understand the difference between credentialing and payor enrollment, as both processes are critical to the reputation and revenue cycle management of the practice.
One frustrating aspect of payor enrollment is that both commercial and government insurance payers have varying processes to enroll in their networks. There can be a long list of rules and requirements to participate, which can result in a lengthy and tedious enrollment process. While many insurance providers aim for between 90-120 days to provide their response, it’s not unusual to face a backlog months longer than that timeline.
This is the best reason to partner with us to help you manage your network enrollments.
Our staff has the knowledge and expertise to manage the entire enrollment process from start to finish. Joining payer networks is a revenue cycle process and is how you get your claims paid. This is a benefit to your client.
PAYER PORTFOLIO MANAGEMENT
As part of our payer enrollment services, we look after your revenue portfolio.
This service includes, VOB, Utilization review, Appeals and claims. We also manage rate negotiations, any renewals or changes that are needed in the directory or contracts.
We are experts at Utilization reviews and the appeals process so you don’t have to.
We know that each claim is vital to your bottom line and a positive claim paid is also a benefit to retaining the relationship with your patients. Your cash flow is our greatest priority.
We look at each opportunity to increase your revenue and profitability.
PAYERS WE WORK WiTH
OUR PROMISE: WE PROMISE TO PROVIDE YOU WITH CREDENTIALING SERVICES THAT WILL INCREASE REVENUE AND DECREASE STRESS.
We know owning and running a business is tough, especially when you’re providing addiction treatment and behavioral health services.
Our promise to you is that while we’re working for you, we’ll provide you with an increased profit and decreased stress.
We offer training and consulting for providers, groups, and facilities including operations, marketing, policy, and procedures, preparing for licensing and accreditation, in-house billing, training, and more.
You’ll be able to focus on what you love doing and helping others, while we take care of the red tape burden or burden of red tape.