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Credentialing and Payor Enrollment Services

Credentialing and Payor Enrollment Services

Garfunkel Health Advisors, Credentialing Division offers a complete suite of credentialing and payor enrollment services for all provider types. We know this process can be time consuming, frustrating, and resource intensive. GHA’s team has a proven track record for getting the job done right the first time, and is committed to excellent customer service.

DOCUMENTATION & CODING -AUDIT SERVICES
Entry and setup of all provider information and documentation necessary for credentialing, recredentialing and payor enrollment:
PAYOR VERIFICATION/REVIEW
Contact each insurance payor by phone, email or both as necessary to verify service, billing and contract status.
Input all information into client database and generate report detailing year to date status with all individual payors by provider.
PAYOR ENROLLMENT/APPLICATION AND SUBMISSION
Complete all necessary steps to enroll provider or correct existing enrollments.
Follow up with payors on status of request every two weeks.
Update client database and provide regular reports of status of enrollments.
RECREDENTIALING RENEWAL/REAPPOINTMENT APPLICATIONS
Continued review and notification of all provider credentialing information needed to maintain payor enrollments/recredential providers, including but not limited to:
CAQH renewals / updates.
Routine demographic updates/verification
Timely responses to all ongoing payor communications and requests.
Other Services include NPI Enrollment, CAQH Implementation, Medicare, Medicaid and Worker’s Compensation Enrollment, and State Professional Licensures Applications and Reinstatements and DEA Registrations.