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Payor Enrollment, Credentialing, Licensing and Management Department

1. Payor Reimbursement & Contracting - initial & recredentialing, as well as Medicare & Medicaid

Identify local market payors
Procure contracts and applications from health plans
Fee Schedule Negotiations
Completion of insurance applications on your behalf, including the CAQH
Submission of the insurance applications to each payor
Follow up with each individual plan until the process is deemed complete & your provider number isissued

Every state, hospital and insurance provider has different rules, regulations, forms and requirements for medical credentialing and this process is very time consuming & can become very frustrating. Biz Solutions industry experts have the knowledge and expertise to get you the extra edge you need to become contracted and ultimately achieve positive cashflow results.

2. Credentialing & Verification Services Application Management - This service is designed to relieve your medical staff and credentialing offices of provider application development and processing. We personally prepare each application for initial appointments and reappointments. We take care of completing the applications on the provider’s behalf, which streamlines the process and improves efficiency and turnaround.

Verification Services - We perform multiple verifications for each provider using an online application, which expedites turnaround time, eliminates duplication and streamlines the process. Our verification service obtains information from all primary sources. Upon completion, we submit completed files to the appropriate credentialing body for review & board approval.

Monitoring Services - With our state-of-the-art credentialing software, we can easily track & monitor each provider's credentials. We monitor and report on expiring state licenses, DEA registration, board certification, hospital affiliations and professional liability insurance.

3. State Medical Licensure Procurement Services.

Our full licensing service includes state board pre-qualification, consultation, recommendations, application preparation & completion of all research, verification forms, queries, routing, tracking, monitoring, expediting, follow-up and follow-through on all applications, verifications, queries, reports and reviews. Again, with our personalized & professional services we are able to expedite the board processes with our thoroughness & follow through and attention to detail. We understand the board process!!!

FCVS Profile Set-Up Services - We take care of establishing your FCVS profile, including the application, all required forms, verifications and follow-up. We take care of all the details, so you don’t have to!!

4. Medical Practice Development & Management Services

1. New Medical Practice Development or Expansion Services
2. Office Management, including executive level management (CEO, COO, CFO, etc.)
3. Risk Management
4. Facility Licensing & Accreditation - Including JCAHO, AAASC, ACR, Medicare, etc.
5. Preparation, review and revision of your Policies & Procedures
6. Medical Transcription Services
7. Preparation of Fee Schedules
8. On-line Bookkeeping with QuickBooks Pro, including Accounts Payable, Accounts Receivable, Reconciliation & Professional Invoicing
9. Financial proforma development, preparing & managing your budget and securing lines of credit for your business
10. Preparation & submittal of THIN & CLIA applications
11. Preparation of Superbill/Hospital Chargesheet Forms
12. Procurement of: insurance (life/disability/malpractice/overhead/d&0, etc.), office furnishings, medical & clinical equipment, medical instruments, hardware & software packages (including specialty EMR, practice management software, RIS & PACS Systems), telecom & office equipment, medical billing services and banking services
13. Research & best recommendation(s) of qualified CPA and attorney/law firm, which is essential to your practice
14. Human Resources:

  • Recruiting physicians, clinical staff and office personnel
  • Negotiating employee healthcare benefits (shopping the market to ensure you receive the best benefits at the best rates), plus 401-K/profit sharing
  • Preparing all policies & procedures, including employee manuals. Negotiating and setting up payroll services

15. Clerical Services

  • Drafting correspondence, mail merge documents, preparing reports, forms, manuals,proposals, and presentations. Proofreading and editing your correspondence and/or reports for accuracy
  • Faxing, e-mailing & scanning documents
  • Ordering office supplies & managing inventory
  • Managing your personal calendar

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