Credentialing & Enrollment
Credentialing is the process of obtaining, verifying, and evaluating the qualifications of a provider and determining whether an applicant is qualified is qualified to be a participating provider with the organization.
Uniserve RCM is happy to aid provider groups as well as clients with a complete range of credentialing services through a time-tested technique that ensures that organizational providers are compliant with state and regulatory bodies before directing membership to these facilities.
Proper credentialing requires a watchful eye on total and stringent compliance with applicable standards. It also requires that applicants are evaluated in the right manner and their competencies are measured accurately. For this, a number of resources are consulted such as the social, academic, and professional history of the applicant, peer and expert reviews, end-user reviews on the quality of the applicant’s services, and more.
The key steps in our credentialing process are as follows:
Highlights
- Full range of credentialing services
- Re-credentialing after every 3 years
- Regular updates of provider data in credentialing and claims systems
- Generation of all pertinent reports like
- HSD Report
- Physician and Facility Reports
- Weekly ADD/TERM report
- Delegated credentialing report
- Group/taxonomy etc. specific ad-hoc reports
At Uniserve RCM, we work with a full team of credentialing veterans who strictly abide by the standards and guidelines set within Medicare Managed Care Manual and National Committee for Quality Assurance (NCQA).