MEDELECT’s Practice Management System & EHR fully integrates with our services listed below:
A/R REVENUE CYCLE MANAGEMENT
- Establishing and monitoring annual reasonable fee schedule using Geographic Practice Cost Index by area;
- Ensuring you are compliant with your patient intake forms; assisting you with correct HIPPA, liability and collection language.
- Collecting accurate information for submission of clean claims;
- Claims submission to all paysources, electronically or manually;
- Tracking claims from submission to payment;
- Rebilling and appealing inaccurate denials using all legal collection remedies, collecting full fee for service payment according to paysource and contract;
- Patient Statements and soft collections; patient copayment, deductible and out of pocket maximum collections;
- Insurance Appeals;
- Process & track Liens and Letters of Agreement (LOA);
- Daily, weekly or monthly deposits of provider payments;
EXECUTIVE BUSINESS MANAGEMENT
- Customized weekly, monthly and annual executive level reporting functions;
- Revenue Optimization;
- Cost analysis;
- Inventory analysis;
- Expense anaylsis;
- Utilization Review;
- Audits.
OFFICE ADMINISTRATION
- Satellite Front Office
- Answering Service
- Eligibility
- Scheduling (Office and Surgery)
- Pre-authorizations
- Out-of-pocket Estimation
- Payment Agreements
- Payroll
CONTRACT & CREDENTIALING MANAGEMENT
- Provider Applications/Agreements
- CAQH Credentialing
- Contract negotiations, monitoring and compliance for all insurance groups
FAQs about Physician/Provider Credentialing
Q: Who do we provide credentialing service for?
A: MEDELECT offers credentialing service for all medical provider types.
Q: What types of credentialing service do you provide?
A: MEDELECT provides credentialing services for providers wherever they practice: private practice, group practice, hospital, ambulatory centers, rural health centers, emergency physician groups, alternative birth centers, etc.
Q: Who can help me with this process?
A: MEDELECT employs full time Credentialing Coordinators. Their job is to make sure each physician stays on course to complete their credentialing paperwork as quickly as possible. For more information call us at 877-543-2824.
Q: What will the credentialing process require?
A: We will send you a Provider Information Packet which is list of all documents and paperwork we will need. This includes but is not limited to (dependent on entity type, state you render services in) a copy of your state driver’s license, medical diploma, internship and residency diplomas, a passport-sized photo, a current CV, your medical license from all states in which you have worked, your Controlled Substance Permit for the state you are rendering services in, your federal DEA permit, your board certificate, your ACLS, ATLS, and PALS or BLS certificates and your NPI number and confirmation letter, tax identification letter and Articles of Incorporation, etc. Your Credentialing Coordinator will send this checklist to you with your applications.
Q: How long will my credentialing take?
A: The credentialing process can be a long one. Many organizations require extensive proof of work history, references, hospital affiliations and medical schools to ensure the quality of their doctors.
Let our coordinator give you an estimate of how long the process will take.
Once you have your state license credentialing can take up to 9 months. However, your state license may take as long as six months to acquire, and some hospitals require you to have your state license to even be considered for a position. Please be patient and thorough with your paperwork to expedite the process.
Q: What can I expect in the process?
A: Once your Credentialing Coordinator receives your file, you will be sent a pre-populated Standardized Credentialing Application and the any other credentialing packet necessary to complete your process along with a return envelope. All forms will be flagged and highlighted for your convenience. You need to return your packet within two weeks to stay on track for your credentialing process to proceed smoothly.
When we receive the packet back in our office, we will review it for accuracy and completeness and forward it on to the appropriate entities. You may require further vetting from an organization which will include back ground checks, verifications for your education, previous work history, past and current hospital affiliations, and peer references.
Please note that each entities credentialing process is different, and more documentation or less work may be required of you depending on the type of credentialing you have selected.
In addition to the provider packet, you will be asked for financial credentialing for billing purposes so we will need any and all provider identification numbers for all states and offices you have worked for or under. The billing office will submit the paperwork necessary to assign Medicare, Medicaid and Blue Cross Blue Shield numbers that will be needed to bill patients and receive reimbursements, as well as specific insurances you indicate.
Q: What is the difference between work history and hospital affiliation?
A: Work history refers to the group that employed you, while hospital affiliation is the facility at which you practiced.