Credentialing
Credentialing takes a lot of time, which can result in a great deal of expense. Berkeley Associates has streamlined the process to maximize investment of resources into a simple, comprehensive method; effectively managing the credentials for all the professionals in your practice.
Berkeley & Associates know how time consuming credentialing and enrollment is for healthcare providers, both for an established practice or setting up a new practice.
Berkeley & Associates is familiar with the process and requirements for credentialing with many insurance companies. We take pride in an efficiency that will ensure enrollment is correct at the time of submission. We know that your practice depends on having contracts in place as quick as possible and that will only happen if we do our job.
Our credential management system improves productivity, saves on staffing expense, and ensures that your credentials will be up to date.
- CCIM is our proprietary software developed over many years to maintain our provider’s credentials.
- CCIM organizes credential documents and provides data management reports for providers. Missed credentials cause contract terminations and failed re-appointments.
- CCIM will create reports and credential documents as a personal database available to you anytime.
- CCIM provides expiration lists to maintain current credential information.
- We provide on-going credentialing service to keep you participating with the insurers and on staff with facilities: tracking deadlines, expiration and renewal dates, and all your re-credentialing requirements.
Credential Maintenance Program
CCIM is a solution for any size practice. The cost of credentialing will decrease as the size of the group increases since we often suggest group contracts, all providers will be under the same terms and adding to the group reduces enrollment time.
Credentialing Program Details
- Our program provides a current Universal Application that is updated as information and documents change
- Updates and expiration dates are reported monthly or on request
- Facility and Payor credential activity is reported for each Professional
- Provides custom reports, letters, and specialty specific data
- CAQH submission and maintenance every 120 days and recorded
Mid-Level Credentials
Insurance payors are requiring Advance Practice Nurses and Physician Assistants to be contracted and credentialed.
NPI and Pecos Enrollment
NPI and PECOS enrollment are critical for future reimbursement for quality measures and e-subscribing. Berkeley Associates have worked on this process with many providers to ensure that they receive they funds that they deserve.
What do you need to start the credential process?
- Current full name
- Other name, when did it change and why
- Date of birth
- Social Security Number
- Current resume
- Place of birth
- State license, DEA, CDS
- Malpractice insurance, with the provider name on the page or attached with a group list if shared limits
- CAQH – log in and Password (if available)
- NPI – log in and password (if available)
- Three peer references