The credentialing and provider enrollment processes can be tedious and time-consuming. Anders Health Care and Fifth Avenue can offer a simplified solution.
The industry average for payer credentialing is 30-180 days. Our solution can complete the process in approximately 15 days for eligible plans through delegated credentialing.
How? One application, multiple health plans. Schedule a meeting with our team to discuss your needs and learn more.
Where do we add value? With our unique payor matrix to manage every step of the provider onboarding process, we organize essential documents and continue communication with insurance companies to ensure a smooth application process. This takes the stress out of bringing on new physicians so you can focus on what matters: helping your patients.
Save Time. Save Money.
Relieve yourself of the administrative burden of time-consuming credentialing and provider enrollment. Our turnkey solution manages every step of the process with accuracy while providing the communication and provider documentation you need.
Provider Enrollment
Enrolling new providers can be a daunting process, but necessary for the organization to process claims and be paid. Anders health care advisors have a wealth of experience in managing all professional licensing renewal needs, including state, controlled substance and DEA applications in all 50 states. Our focus on transparency means our team keeps up continuous communication with the provider until a licensing decision has been rendered by the state board. This gives providers one less worry, adding to their peace of mind. When managing the provider enrollment process, our team uses a payor matrix to handle the entire process from start to finish, including:
Completing and submitting all necessary forms
Working closely with state licensing agents
Ensuring all required documents have been received
Keeping track of recurring license renewals
Delegated Credentialing
Partnering with NCQA-accredited Fifth Avenue Healthcare Services, we help shorten the delegated credentialing process from 52 conventional steps to just six simple ones, allowing physicians to begin billing as much as 60-90 days sooner. Providers are also able to apply for over 25 delegated health plans and networks through a single application rather than dozens of individual ones. This streamlined process saves providers time and revenue. We are currently adding more delegated health plans and network options in Illinois and Missouri.
Our delegated credentialing Missouri payors currently include:
Access Health Services
Careworks
Evolutions Heathcare Systems
First Health
Fortified Provider Network
Friday Health Plans
Galaxy Health Network
Generations Healthcare Network
Humana
MultiPlan
Prime Health Services
USA Managed Care Organization
WellFirst Health
Zelis
In Illinois, our delegated credentialing payors include:
MultiPlan
Prime Health Services
USA Managed Care Organization
In Oklahoma, our delegated credentialing payors include:
Access Health Services
Aetna
Beech Street
The Great Seal of the Choctaw Nation
Coventry Health Care
Global Health
Healthcare Highways
HealthSmart
Longevity Health Plan
Oklahoma Complete Health
United Healthcare
Wellcare
Ongoing Management of Provider Data
When a providers’ credentials or documentation aren’t properly maintained, they can expire, leading to deactivation by payers. Once deactivation occurs, claims can be denied, causing a negative impact to your downstream revenue. Avoiding this requires ongoing monitoring of expiring documents, e.g., certifications, CME, malpractice insurance, etc. Anders uses automated alerts to ensure providers never become inactive with a payer or miss a hospital reappointment because of noncompliance. Anders management of provider data eliminates your need to constantly update spreadsheets or reference calendars to monitor compliance. Our lines of communication are always open so you know exactly where you stand in the process.
Our ongoing management includes:
Health Plan Quarterly Updates
CAQH Profile
Demographic Changes
Payer Roster Reconciliations
Medicare and Medicaid Revalidations
Payer Renewal Applications and/or Rosters
Hospital Recredentialing Application
Data/Document Management Platform
Denial Management
State Medical License Renewal
State Controlled Substance Registration
DEA Registration
Acting Liason between Client, Providers and Credentialing Entities
Anders + Fifth Avenue
Anders and Fifth Avenue Healthcare Services partner to provide streamlined outsourced credentialing and provider enrollment services to minimize the workload of your staff and increase efficiency, leading to reduced turnaround times. Our full-service solution speaks to one of the health care industry’s biggest, yet most essential, responsibilities through:
Simplifying the application process by reducing a 52-step process down to six simple steps
Completing license application renewals efficiently and correctly to save valuable time for providers
Streamlining the application process by allowing providers to apply for over 25 delegated health plans and networks via a single application
Gold standard NCQA accreditation through Fifth Avenue Healthcare Services
