Component 1: Payer Credentialing and Contracting
Components of Our Complete Oncology Billing Solution:
The Oncology Coding, Billing and Reimbursement Experts.
Providing Dynamic Support for Today’s Medical and Radiation Oncology Physicians and Practices.
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RC Billing payer credentialing specialists and contracting representatives will complete every step required for your Medicare, Medicaid, and commercial payer credentialing, revalidation and contracting needs, including payer fee analysis, payer rate negotiation/renegotiation and more. We service both new and existing practices and keep you informed throughout the process.
Payer credentialing and contracting services
RC Billing provides payer credentialing and contracting services to help our billing clients prevail in today’s complex health insurance market. We understand if your other practice demands have not allowed the time to review each payer contract thoroughly or that you may not have reviewed your payer contracts in several years.
Payer credentialing for new practices
If you’re a new practice, we’ll take you through the required payer contracting and credentialing process from start to finish, including:
- Completion of both payer and hospital credentialing applications
- Contract review to ensure language is appropriate and all CPT® codes for provided services are included in your contracted fee schedule to ensure your financial success
- Payer fee negotiation to obtain the highest reimbursement in your market when possible with detailed CPT®/HCPS fee analyses for provider/facility approval and execution
- Complete ERA and required EDI enrollment per payer
Payer credentialing and contacting for existing practices
If you’re an existing practice, we will:
- Review and perform a complete financial market analysis of your existing payer contracts. If you do not have copies of your existing payer contracts, we will obtain executed copies on your behalf
- Review existing contracts for opportunities to renegotiate and present our recommendations for execution
- Complete both payer credentialing and re-credentialing
- Complete EFT, ERA and required EDI enrollment per payer
- Maintain provider/facility credentialing documents and track renewal dates
- Perform follow-ups to make sure payer participation is achieved in a timely manner
- Provide well-established contracting processes that secure our billing clients the highest reimbursement and provide detailed line-item fee analyses for provider/facility final approval and execution
Realize Powerful Profits with the Leaders in Oncology Billing
Leave this to the experts.
Our payer credentialing and contracting specialists will assist you in negotiating/renegotiating contracted commercial payer rates at the time it is permissible per executed contracts.
Let us partner with your Oncology practice!