The Fisher Consulting Group provides full service FQHC credentialing services to help navigate the complexity of provider enrollment for both state and payer-specific programs. Avoid having to put claims on hold for indefinite amounts of time due to provider credentialing delays. Our team can register your new providers and help deliver quicker payment turnaround times on claims.
Part B enrollment is often needed for the state Medicaid program, and commercial Medicare Advantage plans.
Re-credentialing is required approximately every 3-5 years per PTAN, along with submitting new address, bank, and officer information when changes occur.
Medicaid enrollment will vary by state, and some states require that Medicare enrollment is completed before you can begin the Medicaid enrollment.
Most states utilize a unique state standardized credentialing application which can be quite lengthy while capturing all of the provider’s information.
An online credentialing tool that many commercial carriers access to perform the provider credentialing, CAQH will be established or maintained.
All billing providers are required to have an NPI, as it is becoming increasingly involved in the credentialing and billing process.
The FQHC may have a variety of agreements: Facility – Group – Individual. Commercial agreements regularly require re-credentialing for the providers.
“Master" Enrollment forms expedite the completion of often-used forms, ensuring that current forms are used to avoid rejection.
The Fisher Consulting Group maintains detailed records of plan information, the provider roster, and effective dates regarding specific enrollments.