CREDENTIALING MANAGEMENT

Unlimited Credentialing/Re-Credentialing includes on-boarding and monthly monitoring of each provider.

Services include:

Verification

• Confirm roster of providers per location with each carrier
• Confirm providers’ network status with each carrier

Provider Management

• Manage collection and accuracy of provider data. This includes:
  • Apex Credentialing Questionnaire
  • Declaration questions
  • Collect Supporting Documents:
  • Dental License
  • DEA
  • CDS
  • Professional Liability Insurance Declaration Page
  • Management and ongoing reminders for upcoming expiration dates for certificates, insurance, licenses
  • Review each provider’s info to ensure accuracy

Carrier/Payor Management – Unlimited Credentialing/Re-Credentialing

• Request appropriate forms and agreements from carriers
• We will complete the forms and double check for accuracy
• If necessary, we will follow up with our designated contact(s) in the event we need additional provider information
• Forms to be sent to provider for review & signature
• Upon receipt of the reviewed and completed documents, APEX will forward the documentation to carrier

Follow Up Management

• APEX will follow up to ensure carrier receipt and processing
• APEX will notify the provider/contact(s) upon receipt of “in- network” dates per carrier
• Post confirmation of “in-network” dates. APEX will review all data with each carrier to validate accuracy