Proper credentialing is the foundation of timely and accurate reimbursement. We manage the credentialing and enrollment process to ensure providers are correctly established with insurance payers. This ultimately reduces claim rejections, payment delays, and compliance issues.

• New provider and group credentialing with commercial and government payers

• Recredentialing and ongoing payer maintenance

• Enrollment for electronic claims, EFT, and ERA

• Coordination with insurance networks and clearinghouses

• Tracking credentialing status and effective dates

We act as the liaison between your practice and insurance companies, ensuring every provider is credentialed correctly and payments are issued without interruption.

Clean claims are critical to fast reimbursement. Our team prepares and submits claims with precision, ensuring all required data is complete, accurate, and compliant with payer-specific guidelines.

Our claim process includes:

• Verification of patient eligibility and benefits prior to submission

• Accurate CDT code selection and modifier usage

• Correct provider, location, and rendering details

• Proper attachment handling (narratives, x-rays, perio charts, photos)

• Scrubbing claims for errors before submission

• Electronic submission through approved clearinghouses

By submitting claims correctly the first time, we reduce denials, minimize rework, and accelerate cash flow for your practice.

Outstanding claims represent revenue at risk. We proactively follow up on unpaid and underpaid claims to ensure every dollar earned is collected.

Our follow-up and AR management includes:

• Continuous monitoring of claim status after submission

• Timely follow-up on unpaid, delayed, or pended claims

• Identification and correction of denied or underpaid claims

• Appeals preparation and submission when necessary

• Resolution of payer requests for additional information

• Strategic management of aging balances (30, 60, 90+ days)

Our team does not wait for problems to surface. We actively pursue outstanding claims, resolve payer issues quickly, and work to keep your accounts receivable healthy and current.