Provider Credentialing

It’s complex and time consuming. And a must!

Signing up your practice with payers takes a lot of time, even when you do it right. And we can simplify it and greatly reduce the time it takes to be ready with any payer. Below are the provider enrollment services we deliver to our customers.

Application Filing

We send you a complete checklist of all the information and documents required to file the applications. As soon as…

Application Follow-Up

Our team follows up on the submitted application fortnightly, to ensure that the application has been received and is in…

Appeals for Closed Panels

Payers like United Healthcare, Aetna, and Anthem sometimes have closed panels for a particular area. In such an instance, an…

Out of Network Enrollments

For providers that are forced to stay out of network due to closed panels or who choose to stay out-of-network…

Payer Negotiation

Once an insurance company verifies you are competent and qualified to provide patient care services, they will offer you a…

Demographic Changes

We help with all basic and complex demographic changes, such as updating a new TAX ID with all Payers in…

PECOS and CAQH Set-Up and Maintenance

Up-to-date PECOS and CAQH profiles are a necessity in today’s healthcare environment. All major Payers are going the CAQH route…

Credentialing

As an insurance company chooses to move forward with your application, they will need to verify your competence, license and…

Annual Credentialing Maintenance

For healthcare facilities with multiple providers, accurate provider database management is pivotal. We manage and maintain the credentials for all…

Gianni Gonzalez and her team have provided SIMEDHealth with assistance in educating our providers and staff on appropriate documentation. We’ve seen an improvement of over 5% in our overall audit scores thanks in part to the services she has been providing.

Kristin Roberts, MSBA, PHR — Vice President of Support Service @ SIMEDHealth

Let’s Get Started

Please fill out the form here and give us an idea of how to serve you best. One of our representatives will contact you right away.