Insurance Contracting and Credentialing

A medical practice thrives when it achieves its aim of successfully offering excellent services to its patients, boosted by perfectly conclusive results, and all this at the most optimum pricing. Towards this end, a medical practice should concentrate on dealing with its patients, so that they can be given the best care possible. Does this mean that it should be slack regarding its back-end processes? Not at all, especially since it is these very back-end processes that can ensure proper insurance checking and claims, billing processes, and therefore more profits.

Credentialing

A complete practice management solution includes insurance contracting and credentialing, and Akshar Health Care is among the foremost providers of this service. A medical services provider is eligible to start billing private insurance companies only after it has been credentialed. Akshar Health Care can help you verify, assess, and validate yourself as a reputed and credentialed medical facility. Our knowledgeable experts and experienced staff takes care of everything for you – right from the start to the finish. Our professionals have the technology and the know-how to get it right the first time, and can overcome even the toughest credentialing challenges.

The credentialing services that Akshar Health Care takes care for you includes: CAQH registration, commercial insurance credentialing, physician credentialing, managed care & government payer credentialing, workers compensation credentialing, medical license application processing & tracking, DEA registration & tracking, NPI Registration (Type I & Type II), individual and group Medicare enrollment & reassignment, commercial insurance contracting, insurance contract negotiations, payer fee schedule creation & evaluation, and management of all credentials among much more.

Contracting

The process in which an arrangement is made between a medical practice and an insurance company, so that claim payments can be made a smooth and easy affair, is known as contracting. Medical practices across the country require contracting or contract negotiation services, so that claims and collections can be hassle-free. Akshar Health Care can offer your medical practice contracting services as well as contract evaluation services.

The contracting services that are undertaken on your behalf by Akshar Health Care begins with properly reviewing and analyzing any of your current agreements to know the scope of expansion possible. Next, we evaluate your payer agreements and gauge how they compare to regional market standards. Further to that, we have a discussion with you and put forward our proposal of a contracting strategy based on your goals and the current insurance climate. Once you have agreed on the strategy and the blueprint is decided, we determine whether capitation, exclusivity, or preferred provider status is available with any payers. The next step would be to consult with the shortlisted payers regarding pay-for-performance measures and negotiating a fee schedule that works best for the group. Apart from that, our experts also try to determine if you are losing referrals because you’re not participating with certain insurance plans, and try to overcome those drawbacks. Our experienced professionals also help you to develop and implement our plan to renegotiate your insurance agreements. Last but not the least, we provide regular updates of the entire negotiation process, and also conduct regular checks to see if and where re-contracting is required.

To have a smooth sailing and profitable medical practice, all you need is the best possible medical facilities and an experienced service provider like Akshar Health Care who can help you with insurance contracting and credentialing.