Provider/Carrier Participation Analysis 101

One of the unique services that we offer at APEX Reimbursement Specialists is known as Provider/Carrier Participation Analysis or PCPA. This service is a fantastic way to learn more about what networks your providers are participating in, what carrier networks your providers are not on par with and receive additional advice about adding or removing carriers to offices in your network.

What Will You Learn?

Through our expert Provider/Carrier Participation Analysis, your dental practice will gain a great deal of insight into what carriers are providing you with the best results and what carriers it might be time to leave behind. As part of the PCPA, APEX will:

  • Identify all networks in which your providers are participating with per location
  • Identify all carrier networks in which your providers are not par with per location
  • Provide you with detailed recommendations identifying which carriers should be added or removed per location

Many dental offices are so wrapped up in attracting and retaining patients, on top of recredentialing and keeping the practice in the green, that they forget to regularly assess what carriers are the best match for the office. Even if you take time to negotiate with carriers and providers on reimbursement rates, sometimes carriers just don’t work out.

APEX can guide you through the process of identifying what carriers are right and wrong for your practice, in addition to completing the credentialing and reimbursement negotiation processes on your behalf. You’re busy enough running your practice, so why should you spend hours signing up with carriers, recredentialing and negotiating reimbursement rates? With our report detailing which carriers would benefit your practice the most and our assistance with credentialing, you will be uniquely qualified to make the right choices to grow your practice.

What Do We Need from You?

  • An up-to-date list of your offices and practice locations
  • A current roster of providers for each office
  • A current list of carriers for each office
  • A fully-executed LOA and carrier-specific NDAs, if applicable

Provider/Carrier Participation Analysis from APEX

The experts at APEX Reimbursement Specialists can help you to explore the best insurance carrier options for your continued growth and sustained success. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.