Application and Initial Credentialing

  • Credentialing Application (PCS standard, client modified, or state specific) is generated via our credentialing software and available on our web site as an interactive PDF, via email or mail by client request.
  • Upon receipt of completed application, primary source verification of required elements begins and our average completion is less than 45 days.
  • Completed file returned to client electronically and includes a summary of all verified data, the application, supporting reports (NPDB and AMA, etc.) and verification records.

Re-credentialing

  • Re-credentialing application pre-populated with data from initial PCS credentialing record Initiated and sent to the provider 4 months prior to expiration of initial credentialing file.
  • Upon receipt of completed application, primary source verification of required elements begins and our average completion is less than 45 days.
  • Completed file returned to client electronically and includes a summary of all verified data, the application, supporting reports (NPDB and AMA, etc.) and verification records.

Dynamic Credentialing

  • Monitor and obtain current records for expiring documents (license, liability insurance, DEA, etc.) between credentialing cycles.
  • Update forwarded to client electronically for insertion in master file.

Delegated Credentialing Oversight Audits

Healthcare entities who offer delegation of the credentialing process to networks, hospitals, or large provider groups must perform delegated credentialing oversight audits on a regular basis.  Precision Credentialing Services performs these audits for our clients who offer delegation.  Audits include policy review and electronic file review for initial and re-credentialed providers.

Provider Contracting and Paneling Services

  • Research provider contracts/panels available
  • Obtain contracts, applications and credentialing forms for preferred provider participation or hospital privileges
  • Electronically populate critical forms for submission to provider or group for review and signature
  • Submit all required documents to contracting/paneling/privileging contact and then follow the process unti provider has received determination of request
  • Monthly maintenance (maintaining all provider files and updating paneling documents as required, including CAQH every 120 days) rates available or hourly rates for one-time or special projects
  • Interactive forms management and storage of provider credentialing data electronically

Document/Forms Conversion

Unfortunately, some healthcare entities have not yet invested in electronic/interactive forms for providers to complete via computer and many of these forms are being hand completed.  This takes a huge amount of time away from your provider’s ability to care for their patients.  In addition to time, poor handwriting causes delays in contracting, paneling and credentialing being performed.  Applications, contracts, etc. are scanned and converted to interactive documents.  Document conversion services are provided by our Provider Contracting and Paneling Services Dept.

Network Management

Our network management team has a proven track record in the development and management of provider data.  Outsourcing network management is a cost effective way to deal with new regulations requiring health plans to control administrative overhead.  In addition to primary source verification, the credentialing process is central to the management of provider demographics, continuing education, sanctions, and can be the direct source for application for privileges, membership, or participation.