Credentialing Services

Practicing medicine is difficult in today’s complex world of compliance, systems, and paperwork.   The provider enrollment process is no different – it is detailed, intricate and cumbersome.

Kaleidoscope’s Credentialing bring you an outsourced solution that is affordable and efficient.   We work with the payers you chose and ensure your applications are processed timely and correctly.   We work on your behalf from the point of application submission through claim adjudication and payment.


Our Comprehensive Solution for you:

  • Full service enrollment and re-enrollment solution

  • Save time and eliminate the complexities that the provider enrollment process entails.

  • Experienced, professional team with over 25 years of experience.

  • Dedicated account manager will manage every step of the process.

  • Extensive experience working with payer credentialing departments.

  • Focus on clean applications to prevent application rejections.

  • Assertive follow-up with necessary phone calls, faxes or emails and track the status of each application. This ensures that the process is completed efficiently and in a timely manner.

  • Regular Status Update Reports and phone conferences or meetings as you desire.

 

Our Services Include:

  • Provider enrollment with government plans and major commercial carriers.

  • Expertise in submission processes with Apply Smart, CAQH and Pecos.

  • Re-credentialing with all payers.

  • Dedicated application follow-up to ensure that are payers are actively processing your applications.

  • Tracking the status for all applications submitted with efficient turn-around time based on payers timelines

Timeline for Credentialing:

The turnaround time to credential with the payers will vary from payer to payer and will be longer if the provider or group is newly established.   The process typically ranges from approximately 60-120 days.  Most payers do not backdate effective dates so it is imperative to coordinate the provider’s actual date of providing patient care to the effective date of each network that you are participating in.

Maintenance and Organization Service:

Kaleidoscope will provide ongoing maintenance service to ensure that your revenue is not compromised when it is renewal or re-credentialing time.   Failure to meet renewal dates may result in a provider’s loss of the ability to bill or even see patients.   We will track renewal dates and maintain copies of your documentation.   This relieves you of the need to staff this process and you can focus on quality patient care.