Enroll, Expand, and Excel

Offering Seamless Provider Enrollment Services, Including Credentialing, Payer Enrollments, and More

Elevate Patient Care With Seamless Provider Enrollment

At Affordable Physician Services, LLC, we understand that your primary focus is on providing unparalleled care to your patients. That's why we specialize in taking the administrative load off your shoulders with comprehensive provider enrollment services. From credentialing and re-credentialing to payer enrollments and demographic changes, we cover all aspects of provider administration, ensuring you can concentrate on what you do best.

Comprehensive Services

We offer a broad range of services designed to streamline your practice's operations, including:

Credentialing

Our credentialing services involve assisting healthcare providers in the initial application process to become credentialed with insurance payers.
We meticulously review and compile necessary documentation, ensuring compliance with payer requirements and industry standards.
Our goal is to streamline the credentialing process, minimizing delays and ensuring providers can promptly begin accepting patients covered by various insurance plans.

Re-Credentialing

Re-credentialing involves the periodic renewal of provider credentials with insurance payers to maintain participation in their networks.
We proactively manage re-credentialing timelines, assisting providers in submitting required documentation and updates in a timely manner.
Our team ensures that providers maintain their eligibility for reimbursement and avoid disruptions in patient care due to expired credentials.

Payer Enrollments

Payer enrollment services encompass assisting providers in enrolling with Medicare, Medicaid, private/commercial payers, and insurance companies.
We guide providers through the complex application processes, helping them navigate payer-specific requirements and documentation.
We aim to expand providers' access to diverse patient populations by facilitating participation in multiple-payer networks.

Managing Demographic Changes

We assist providers in updating their demographic information with insurance payers to ensure accuracy and completeness.
Changes such as address updates, practice additions, or provider status modifications are managed efficiently to maintain clear communication channels with payers and patients.
Our proactive approach helps prevent billing and reimbursement issues resulting from outdated or inaccurate provider information.

Handling Miscellaneous Projects and Data Entry

In addition to core credentialing and enrollment services, we offer support for various miscellaneous projects and data entry tasks.
This may include organizing and digitizing documents, entering provider information into databases, or assisting with special projects as needed.
Our flexible support ensures that providers can delegate administrative tasks effectively, allowing them to focus on patient care and practice management.

CAQH Maintenance

We provide comprehensive support for CAQH (Council for Affordable Quality Healthcare) setup and maintenance.
Our services include initial setup assistance, updating provider profiles, managing attestations, and ensuring ongoing compliance with CAQH requirements.
By maintaining accurate and up-to-date CAQH profiles, providers can streamline the credentialing process and enhance their participation in payer networks.

Expirables Management

Our expirables management service involves monitoring and managing expiring credentials, certifications, and licenses for healthcare providers.
We maintain detailed records of expiration dates and proactively remind providers of upcoming renewals to prevent lapses in credentials.
By staying ahead of expiration dates, we help providers maintain continuous eligibility for participation in payer networks and regulatory compliance.

Streamlined Provider Solutions

We serve a diverse clientele, from small to large practices, including FQHCs, and partner with consulting firms to deliver the best results. Our background in billing gives us a unique edge, allowing us to navigate the complexities of insurance enrollment and provider relations across various states effectively. We understand the intricacies of the claims process and how to optimize it for your benefit, ensuring a seamless integration of all components for your practice.

Why Choose Us

Choosing Affordable Physician Services, LLC means partnering with a team that is as committed to your practice's success as you are. We pride ourselves on our ability to handle the intricate details of provider enrollments, credentialing, and more, so you don't have to. Let us take care of the administrative side of your practice so you can focus on what matters most - your patients. For more information, feel free to get in touch.

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FAQS

Why Credential?

Being credentialed with insurance payers can offer an increase in the number of patients in need of your services. Most payers will put you in their directory, which will drive business to you.

Do I Get to Choose the Payers I Enroll With?

Yes, absolutely! We encourage you to provide us with a list of payers you want paneled with.

How Many Payers Should I Start With?

We suggest starting with at least 7 payers. This does not have to be an exact number. We are flexible and will work with you at your own pace. We do recommend having Medicare and Medicaid completed first if these payers are on your list.

How Can I Track My Payer Enrollment Status?

Easy. We will provide you with a monthly spreadsheet that tracks your enrollment status. If a payer provides approval details, we will reach out immediately to update you. We understand the urgency for your practice to get patients scheduled as quickly as possible.

What is CAQH?

CAQH stands for Council of Affordable and Quality Healthcare. Most commercial payers require that you have a CAQH profile before enrolling with them. Payers use CAQH to verify the information we are sending over in your Enrollment.

What is the Difference Between a Type 1 NPI and a Type 2 NPI?

Type 1 NPI is attached to the provider. Type 2 NPI is attached to the organization. We encourage anyone who owns a business with a tax identification number to have a type 2 NPI. As you grow your practice and add providers, this will become especially important. Your providers will be linked to your business group, which is who would be paid for services rendered.

Once Credentialed, Am I Always Credentialed?

No. You will be required to re-credential with your payers, usually every 2-5 years, depending on the payer.

Do You Provide Medical Billing?

Although we do not offer billing services, we do have staff with over 20 years of experience in the field. We also work with several billing services nationwide. We will be happy to connect you with a billing service provider that fits your needs and budget. Further, our billing service providers love working with us. Our service to you does not stop at Enrollment. If there are billing issues that arise after Enrollment, we can help. We work as a team with you and your billing service provider to resolve any issues that arise. Billing and Enrollment are separate departments, usually with the payer, and do not always communicate with each other. This is where it is beneficial to you for your enrollment provider to have experience on both sides. This allows us to help get issues resolved quickly and effectively.

What is Needed for Credentialing?

We have a checklist! However, there are some things you will need to have ready in order to start the process with us.

Tax ID- It is extremely important that you keep your IRS document with your tax ID in a secure location and do not misplace it.

Bank Account - You will want to have your bank account set up already. Word of advice: make sure your information from your IRS document matches how you're shown on your bank account. We cannot stress this enough! If your IRS document says LLC, your bank name needs to read LLC. If your IRS document has spelled out Limited Liability Corporation, your bank name needs to read Limited Liability Corporation. This also includes punctuation. If this differs, you will need to make changes so that the two match exactly. Some payers will deny your application just for this reason alone.

Malpractice Insurance - Coverage amount can differ with payers. However, it is usually safe and recommended to go with a policy of 1m/3m.

NPI- You can file for these at NPPES. If you would rather us do this for you, we can do that.

What if I Require a Supervising Physician?

Credentialing Enrollment with payers varies depending on the payer. Some will approve of your agreement. Others will also require your Physician to be enrolled with their network for your Enrollment to be approved.

How Long Will the Enrollment Process Take?

We are transparent about timeframes with our clients. You are typically looking at 90-180 days, depending on the payer. We will put in for escalations when available to help hurry the process along.