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Credentialing
  • Over 10 Years of Credentialing Experience
  • Member of NAMSS
  • Nationwide Services
  • Fee Schedule Negotiations
  • Re-Credentialing Options
  • Increased Profitability
  • Physician Satisfaction

Credentialing

Enterprise Medical Solutions has partnered with dozens of providers and healthcare facilities nationwide to serve the ever changing credentialing needs of practitioners. We are extremely committed to improving the full physician revenue and credentialing experience through convenience, ease, accuracy, and timely delivery.

We have developed solutions to help physicians and healthcare facilities stay ahead of new credentialing rules, regulations, and trends that potentially, if not implemented correctly, will cost a significant amount of revenue loss. Our solutions will enable your practice to fully realize the benefits of improved productivity throughout the entire credentialing and revenue cycle. Most importantly, we provide the education and follow-up for this solution that ensures that your company can ramp up quickly and realize concrete improvements in revenue management, physician satisfaction, and credentialing metrics.

Superior Contract Negotiations with all Commercial Payers

At Enterprise Medical Solutions we strive to have the ultimate best results for all providers receiving credentialing services. While other credentialing companies do not spend any time on negotiating the fee schedule for the provider, we take that responsibility extremely important. This contract negotiation sets the stage for increased profitability and physician satisfaction. We utilize the most current and proven formulas to base our negotiations and with the many relationships that we have built over the years at various insurance companies.

Re-Credentialing Rules and Regulations at the Payer Level

As part of our credentialing services we know that not just an initial application is important, but we understand how the re-credentialing process is just as, if not more important, than the initial application. Per the state and federal guidelines, credentialing is required of all payers, however, commercial payers can require re-attestation every 90-120 days and then full re-credentialing applications in addition. On the governmental side of re-credentialing their requirements are not as stringent, however, they do require file and data maintenance every 3 years. With that being said, we include re-credentialing within the first year and then the following consecutive year in our initial credentialing services. Re-credentialing thereafter is an additional optional service we provide to ensure accuracy and streamline data maintenance at all payer levels with minimal to no work needed from the providers.

Education and Certifications in the Credentialing Field

As a credentialing company we are members of NAMSS (National Association Medical Staff Services). This membership includes more than 4,500 medical staff and credentialing services professionals from medical group practices, hospitals, managed care organizations, and CVOs. In addition to this membership, we attend ongoing seminars and workshops directly from CMS and Medicaid services nationwide, to ensure we are current and up to date on all changes and current governmental regulations.

Physician Moral and Satisfaction Improvement

Physician's morale and satisfaction will be enhanced by the virtue of services delivered. The needed education and knowledge of understanding will be upheld and explained throughout the entire process. The superior customer service and support by the team at Enterprise Medical Solutions is always the client's first priority.

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