Services We Provide
Credentialing
- Delegated to perform credentialing for network affiliations.
- Initial credentialing and re-credentialing every three years.
Provider Relations
- Liaison between physician and third party payor/insurance networks.
- Disseminate new membership information and physician changes to networks.
- Webpage links with third party payor/insurance organizations.
- Conduct meetings for members and administrators.
- Membership news updates.
Contracting Support
- Third party payor/insurance network contracting issues.
- Claim issue resolutions.
Messenger Model Procedures
- Contract summary.
- Fee offer communication.
- Contract language analysis.
- Communicate information responses to third party payor/insurance networks.
Antitrust Compliance
- Antitrust policy network administration.
- Annual antitrust developments.
Network Affiliations
- Aetna/Coventry
- Amerigroup
- CareSource
- Multiplan/PHCS
- NovaNet, Inc.
- Peach State Health Plan
- Prime Health Services
- Three Rivers Provider Network
- Tricare
- United HealthCare (credentialing only)
- Wellcare