Provider Enrollment & Credentialing

The provider enrollment/ credentialing process with the payors can be an extremely painful process, and if not done properly, can COST YOU LOTS OF MONEY IN LOST REVENUE

Red tape, endless forms, filling out the same information over and over is a waste of your practice's time. Your staff's time is valuable. They should be supporting you and helping patients, not wading through paperwork.

That's where Go-Tech's provider enrollment and credentialing services can help. Partnering with Go-Tech allows you to focus on patient care - while we deal with the headaches that come with the credentialing process.

Whether you are:

  • Opening a new practice
  • Adding a new healthcare provider to your existing practice
  • Contracting with new health plans
  • Trying to ensure an existing provider's ability to be paid

We work with providers in all 50 States, including physicians, hospitals, ASCs, sleep labs, diagnostic testing facilities, rehabilitation (PT, OT, ST) providers, DME, dialysis centers, podiatrists, chiropractors, optometrists, audiologists, and more.

What are the Consequences of Not Obtaining Timely Credentialing?

Obtaining adequate Professional Credentialing to partnering insurance carriers could take up to 6 months. A medical office should include one very important rule in their financial policy. Do not allow any medical office professional to perform services without proper Credentialing.

The results of not obtaining proper Credentialing can result in lost revenues. Insurance carriers will not reimburse any medical office that bills for professionals or for services provided by professionals that have not been properly credentialed.

If for some reason you have allowed a professional to perform services, some insurance carriers will back date your reimbursement to cover services provided. However, there is a limit to the time frame. Taking that risk could cost your medical office thousands of dollars that can never be collected from the insurance payer or the insured.

The safest and most financially viable solution is to submit your provider enrollment packet including any required documentation and verifications as quickly as possible. The success of your medical office depends on it.

Services include, but are not limited to:

  • Commercial Payor/ Health Plan Enrollment
  • Medicare Enrollment (Individual and Group numbers/ Reassignment)
  • Medicare Revalidation
  • Medicaid Enrollment
  • NPI Registration (Type I and Type II)
  • CAQH Registration
  • Provide contract and fee schedule analysis
  • Rate and language negotiation
  • Provide final fee schedule and health plan rates to billing department or billing company
  • Complete all necessary credentialing requirements for each payor and follow through to completion
  • Follow all payor contracts through to contract load date and provide copy of fully executed contract
  • Monitoring of expirations of MA registrations, DEAs, and CLIA registrations
  • Processing re-credentialing applications on an as-needed basis