Streamlined Credentialing and
Provider Enrollment

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.

Effortless Provider Onboarding

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

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