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Turn to ProMD for your health care insurance Practitioner Contracting and Physician Credentialing needs

Managed care and government payer contracting and physician credentialing can be difficult and time consuming processes, but today's medical service landscape requires them.

The complexity of the process, and the level of detail required by some institutions for physician credentialing, is often beyond the scope of many medical practice staffs. Even the most competent and focused individual will undoubtedly be pulled away from other duties and responsibilities trying to navigate the demanding requirements.

ProMD Practice Management staff has extensive experience with and a deep understanding of, the managed care system.  We will use our expertise and established industry relationships to help you negotiate contracts that are in line with the quality services you provide.  

ProMD managed care and government payer contracting services include: 

1. Set up and/or keep up-to-date CAQH profiles 

Monitor expirables with CAQH and payers including but not limited to licenses, DEA, malpractice insurance, hospital privileges 

Complete and submit unlimited enrollment applications and Hospital privileges applications

Follow up on enrollment applications until processed

Monitor CAQH profile

2. Contract re-negotiation 

3. Individual Contracting (new contracts)

4. Add new Providers to existing Group Contracts

5. New Practice Contracting

Want to learn more about physician credentialing? Contact ProMD today.

Today’s managed care companies and government health care payers require credentialing to ensure that medical practices and physicians meet their health care provider requirements. Hospitals also require physician credentialing before allowing hospital appointments or visits.

Physician credentialing is a very thorough, and time-consuming procedure requiring confirmation of licenses obtained, residency programs completed, services provided, and other qualifications such as references from colleagues and industry professionals. Furthermore, it could include investigations into liability claims and Department of Health and Human Services status.

ProMD physician credentialing experts will streamline this process by performing in-depth research and obtaining all pertinent documents. With ProMD at your side, you will experience a smooth and speedy credentialing process.

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”I have been very impressed with ProMD’s overall professionalism, billing performance and overall company integrity. ProMD personnell walked me step-by-step through complex billing issues and helped streamline the process with ease. They have the experience to guide a new physician and improve performance for an established practice. With ICD-10 coming, I am glad we have these professionals to help us."
- Rahil Malik, MD - “Sunlife OB-GYN” – Plantation, Florida