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Credentialing

Credentialing

Credentialing is an essential part of the medical billing process and can be overwhelming to handle in-house. Whether you are a new physician, adding a physician or location to your group, or would like to join additional insurance carriers, we can assist you in filing all necessary paperwork and keep your CAQH profile up-to-date.

Insurance Requirements

Insurance credentialing is a problem every practice struggles with. Whether it is a Medicaid processor, a new HMO, or a new VA contractor, every practice needs someone who can work with insurance companies and file the necessary paperwork to get your practice in-network with plans in your area. Alpha Solutions has extensive history with credentialing brand new practices, adding new locations, changing demographics, and enrolling with new plans. We also understand how credentialing issues can affect your bottom-line so we work diligently with your insurance carriers to get your providers in-network as quickly as allowed.

Our Solutions

If you are a new entity, have a new provider, or have specific credentialing issues, we can develop a one-year agreement to handle all of your issues regardless of how long it takes to resolve. For example, a new practice may want to credential with all insurances. We will create a one-time fee for all credentialing issues within the next year to resolve. This allows the provider to feel confident that they will have all of their issues handled with a one-time fee.

Our current billing clients will have ongoing maintenance of credentialing issue covered as part of the contract. For example, maintaining the CAQH and provider directories will be included within the contract.

  • Credentialing for a new provider/practice
  • Credentialing for a new location
  • Ongoing maintenance of provider directories and the CAQH Profile
  • 12 month contracts created to handle any credentialing issues that arise
  • Credentialing with any new products for your area such as a new Medicaid MCO, new HMO or new VA provider

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