Provider Enrollment and Credentialing

Streamline Your Revenue with GM Analytics Solutions

Provider Enrollment and CredentialingProvider Enrollment and Credentialing can be a cost-effective solution for healthcare providers, enabling in-network payments for patient services. However, navigating the complexities of this process can be time-consuming and challenging. GM Analytics Solutions specializes in facilitating provider enrollment to ensure prompt payments and reimbursements. We manage your end-to-end Provider Enrollment Services (PES) needs, including documentation, enrollment, payer portals, revalidation, and more.

Provider Enrollment Services (PES)

  • Contract Negotiations: We handle all contract negotiations to secure favorable terms with payers.
  • Commercial Insurance Enrollments and Credentialing: Our team ensures seamless enrollment and credentialing with commercial insurance providers.
  • Medicare and Medicaid Enrollment and Credentialing: We oversee the complete process of Medicare and Medicaid enrollment and credentialing.
  • Medicare and Medicaid Revalidation: Our experts manage all Medicare and Medicaid revalidation requirements.
  • CAQH Registration & Maintenance: We take care of your CAQH registration and ongoing maintenance.
  • NPI Registration (Type I and Type II): We manage your National Provider Identifier (NPI) registrations for both individual (Type I) and organization (Type II) providers.
  • PECOS: Our team ensures accurate and complete PECOS registrations.

Benefits

  • Reduced Administrative Burden and Costs: We take on the administrative tasks, reducing your workload and costs.
  • Expedited Payer Enrollment: Our thorough and accurate submission process speeds up payer enrollment.
  • Reduced Denials: Our focus on thorough and accurate documentation minimizes the likelihood of denials.
  • Increased Reimbursements: Efficient enrollment and credentialing lead to increased reimbursements.

How It Works

At GM Analytics Solutions, we start by reviewing and ensuring that all necessary documentation is in order before submitting your information to payers. We verify that all licenses, certifications, group names, Medicare/Medicaid TINs, malpractice insurance, and other relevant details are accurate and consistent across all paperwork, ensuring your application is accepted the first time. We handle your initial enrollment and keep your information up-to-date on CAQH.. Our team keeps you informed about re-enrollment and expiration dates, acting as your advocate and liaison with payers.

Ongoing Monitoring

At GM Analytics Solutions, we understand that securing credentials is just the beginning. Continuous monitoring is essential for long-term success. Our experts collaborate closely with your back-office staff to monitor claim statuses and denials. We review denial reasons and codes, and assess your original contracts to ensure proper payments.

We believe that your revenue cycle is not a static process but an evolving, dynamic system requiring constant attention for the success of your practice and, ultimately, the care of your patients.

EDI Enrollment Services: Enhance Efficiency and Accuracy with GM Analytics Solutions

Overview

Enrolling in Electronic Data Interchange (EDI) can be a cumbersome process that drains clinical and administrative resources, especially in environments using older, legacy systems. GM Analytics Solutions can alleviate these administrative burdens by helping you establish Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) authorization agreements for all providers across multiple clearinghouses or payers. This support allows you to focus your internal resources on complex challenges while benefiting from the efficiencies of electronic claims, remittance, eligibility, and claims status.

EDI Enrollment Services Provided

  • Experienced Support: We ensure a smooth enrollment process and compliance with industry standards.
  • Service Provider Recommendations: We recommend EDI service providers that align with your specific needs.
  • Information Collection and Form Completion: Our team collects all required information and completes enrollment forms.
  • Documentation Submission: We handle the submission of documentation or certifications requested by the EDI provider.
  • Testing, Integration, and Security Review: We support you in facilitating testing, integration, and security review to ensure a seamless transition.

Benefits

Faster Submissions and Reimbursement

With electronic data exchanges and automated validation checks, EDI enrollment accelerates transaction processing and helps identify and correct errors, preventing rejected claims or discrepancies.

Track Claims and Payment Status

By enrolling your organization in EDI, GM Analytics Solutions helps you closely monitor claims, examine historical claims’ payment statuses online, and categorize submitted claims through a structured tracking system to enhance efficiency.

Reduce Administrative Burdens

EDI enhances data exchange by reducing manual entry, processing time, and the potential for human errors. This results in faster, more precise, and more reliable transactions, reducing stress on your team.

 

Partner with GM Analytics Solutions to streamline your EDI enrollment and enhance your organization’s efficiency and accuracy. Reach out to us today to discover more about our services and how we can meet your needs.

 

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