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To ensure that healthcare providers are able to offer their services, bill insurance companies, and comply with regulatory requirements, provider credentials are essential. By being credentialed, patients are assured that healthcare professionals are qualified and properly credentialed. Tausch provider credentialing services are tailored to meet the specific needs of the provider and are designed to streamline the application process. We act as an advocate for the applicant throughout the entire process.Tausch Medical also provides credentialing support services to ensure providers maintain their credentials and remain compliant and active with all regulations.
Data Gathering: Collect all necessary information and documentation from the healthcare provider, including licenses, certifications, education records, and work history.
Verification of Credentials: Verify the accuracy and legitimacy of the provided credentials, including licenses, certifications, and degrees.
Application Submission: Prepare and submit credentialing applications to insurance companies, government agencies, and healthcare organizations.
Provider Enrollment: Complete the enrollment process with insurance plans and government healthcare programs like Medicare and Medicaid.
Insurance Contracting: Negotiate and establish contracts with insurance companies, outlining reimbursement rates, terms, and conditions.
Follow-Up and Status Tracking: Monitor the progress of credentialing applications and regularly follow up with organizations to ensure timely processing.
Compliance with Regulations: Ensure compliance with all relevant healthcare regulations, including those related to HIPAA (Health Insurance Portability and Accountability Act) and state-specific requirements.
Provider Updates: Keep all provider information up to date with relevant agencies, insurance companies, and healthcare organizations.
Document Management: Maintain comprehensive records of all credentialing documents, including applications, verification reports, and contracts.
Recredentialing and Ongoing Maintenance: Continuously monitor and maintain provider credentials, as they may expire or require periodic recredentialing.
Appeals and Resolutions: Handle appeals and disputes related to denied applications or any credentialing issues that may arise.
Quality Assurance: Implement quality assurance processes to ensure the accuracy and efficiency of credentialing procedures.
Provider Support: Provide support and guidance to healthcare providers throughout the credentialing process and address any questions or concerns they may have.
Reporting: Generate reports and maintain records to track the status of each provider's credentialing and enrollment.
Including many others...
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