Contracts & Credentialing

Do you wonder what it costs your practice to do your own Contracts & Credentialing?

In addition to staff time doing the research, completing the paperwork and following up with each agency and payor, it is fairly common for practices to miss revenue before they ever see a patient. How? By not fully securing payor contracts before seeing patients.

At Healthcare Management Systems, we establish favorable physician contracts by knowing the procedures and protocols that secure timely approval and the initiation of cash flow. Our staff  includes reimbursement specialists who continuously monitor your contract status to ensure reimbursements arrive in compliance with the terms of each third-party agreement. We facilitate provider enrollment with all commercial and government payors in all 50 states; manage Medicare, Medicaid  state and county enrollment; and credentialing revalidation for all medical professionals nationwide

HCMS staff fully understand the necessity of maintaining favorable terms for our clients. Each HCMS client has a personalized “contract calendar” to ensure we eliminate any date gaps or missed reimbursements. Our experienced professionals efficiently navigate the complex contractual systems that can overwhelm inexperienced office staff.

Physician Credentialing

As you know, each contracted payer and entity has unique credentialing periods and requirements. Your credentials must be kept current or your contracts may lapse and reimbursement eliminated. We secure, complete and track the paperwork necessary to keep your physician credentialing valid.

With physician credentialing, Healthcare Management Systems understands the necessity of securing and maintaining preferred provider status. If you have questions about the processes, and what is required to maintain “in good standing” status, please click below to download forms regarding Cost and Best Practice Solutions to Contracting and Credentialing.

Download Cost & Solutions PDF

“The HCMS staff is diligent, experienced and easy to work with. Kris Jones-Bartley’s level of attention to detail is such that I don’t have to worry about something falling through the cracks. This is critical in contract negotiations, credentialing and practice administration.”