Provider Enrollment & Credentialing
We guarantee that you receive the reimbursements owed to you at Sigma RCM
Provider Enrollment and Credentialing is a cost-effective solution for healthcare providers, facilitating in-network payment for patient services. However, navigating this process can be time-consuming. At Sigma RCM, our Provider Enrollment Service (PES) team specializes in streamlining this process to ensure prompt payments and reimbursements. We handle all aspects of your PES needs, including documentation, enrollment, payer portals, revalidation, and more.
Provider Enrollment Services (PES):
- Negotiation of contracts
- Enrollment and credentialing with commercial insurance providers
- Enrollment and credentialing with Medicare and Medicaid
- Revalidation with Medicare and Medicaid
- CAQH Registration & Maintenance
- NPI Registration (Type I and Type II)
- PECOS
Benefits:
- Reduced administrative burden and costs
- Expedited payer enrollment with accurate information
- Decreased denials
- Increased reimbursements
How it Works: Our team ensures all necessary documentation is in order before submitting your information to payers. We verify the accuracy of licenses, certifications, group names, Medicare/Medicaid TINs, malpractice insurance, and more to increase the likelihood of acceptance on the first submission. We manage your initial enrollment and maintain your information on CAQH, notifying you of any re-enrollment requirements or expirations. We serve as your advocate and liaison with payers.
Ongoing Monitoring:
Sigma RCM understands the importance of monitoring the outcome of enrollment and credentialing efforts. Our experts collaborate closely with your back-office staff to monitor claim status and denials. We review denial statuses and reason codes, ensuring proper payment alignment with original contracts.
At Sigma RCM, we recognize that the revenue cycle is a dynamic process requiring constant attention for the success of your business, practice, and ultimately, patient care.