Credentialing & Compliance

Ensuring Seamless Credentialing and Regulatory Compliance

At Centriix, we understand that credentialing and compliance are vital components for healthcare providers to remain operational, bill insurers, and get reimbursed promptly. Our comprehensive credentialing and compliance services are designed to make sure your practice meets all regulatory requirements, maintains up-to-date credentials, and avoids costly penalties. We handle all aspects of the credentialing process—from initial application submission to ongoing monitoring of credentials—so you can focus on patient care while we ensure your practice stays compliant with industry regulations.

Sub-Segments We Cover

Provider Credentialing

We assist healthcare providers in getting credentialed with payers and insurance companies. Our experts handle the application process, ensuring all required documents are submitted and processed accurately, reducing delays.

Credentialing Maintenance

We continually track and manage the expiration of credentials, ensuring that your providers' credentials remain current and valid. We handle re-certification processes and make sure all updates are completed in a timely manner.

Regulatory Compliance Monitoring

We keep your practice in line with constantly changing healthcare regulations. Our compliance experts monitor and implement any new regulations that impact your practice, ensuring you’re always compliant with federal, state, and payer-specific guidelines

Government & Private Payer Enrollment

We help you navigate government and private payer enrollment processes, ensuring you meet all the specific requirements for participating in both Medicare, Medicaid, and private health plans.

Audit & Documentation Management

We ensure all your documentation is in order for potential audits. Our team helps you prepare for and manage audits, ensuring that all documents required for the credentialing and compliance process are readily available

Initial Consultation & Documentation Review

We begin by conducting an in-depth consultation to understand your practice's credentialing needs. We review all the necessary documentation required for the credentialing process.

Credentialing Application Submission

Our team submits the credentialing application on your behalf to insurance companies and regulatory bodies, ensuring that all information is accurate and complete.

Credential Verification

We verify the credentials of your healthcare providers with national organizations and ensure all licensing, certifications, and qualifications meet the required standards.

Compliance Monitoring

After the credentialing process, we continue to monitor all credentials and regulatory compliance, updating records and making necessary submissions as certifications approach expiration.

Audit & Documentation Preparation

We prepare all the necessary documentation for audits and ensure your practice meets all requirements in case of an audit, minimizing the chances of penalties or delays

Numbers That Matter

At Centrixx, we empower businesses with smart solutions that simplify complexity and drive growth. Combining advanced technology with industry insight, we help clients stay ahead in a changing world. Our mission is to deliver reliable, scalable solutions while building lasting partnerships for long-term success.

Compliance with Healthcare Regulations

Successful Credentialing Rate

Faster Credentialing Process

Provider Enrollment with Top Payers

Providers Credentialed Annually

Our team ensures that credentialing applications are processed swiftly, reducing the average time it takes for providers to be fully credentialed with insurance companies

We continuously monitor your compliance status to prevent any lapses in certification and ensure that all required updates are completed on time.

By ensuring that your providers are properly credentialed and compliant with payer requirements, we help avoid delays in reimbursements, accelerating cash flow.

We help prepare your practice for audits by keeping your documentation organized and ensuring that you’re always ready for regulatory inspections or payer reviews.

What We Offer

Provider Credentialing Services: We assist in credentialing your healthcare providers with insurance companies, ensuring timely and accurate applications

Ongoing Credentialing Maintenance: We keep track of all credential expiration dates and assist with re-certification processes to avoid lapses.

Regulatory Compliance Monitoring: Our team ensures that your practice stays compliant with all relevant regulations, including HIPAA, state laws, and payer-specific guidelines.

Payer Enrollment Assistance: We help you enroll with both government and private payers, ensuring your practice has access to a wide network of health plans.

Audit and Documentation Management: We ensure all your documentation is organized and ready for audits, minimizing risks during payer reviews.

Frequently Asked
Questions

How long does the credentialing process take?

Credentialing typically takes anywhere from 30 to 90 days, depending on the payer and the type of credentialing. However, we work diligently to expedite the process.

What happens if a provider's credential expires?

If a provider’s credential expires, they may be ineligible for reimbursement. We monitor all credential expiration dates and manage the renewal process to prevent any lapses.

Can you help with both government and private payer enrollment?

Yes, we assist with enrolling providers with both government programs (e.g., Medicare and Medicaid) and private insurance companies

How do you ensure compliance with changing regulations?

Our compliance experts stay updated on industry regulations and ensure your practice remains compliant with federal, state, and payer-specific guidelines.

Do you offer audit support?

Yes, we prepare and manage all documentation needed for audits, ensuring your practice is ready for any potential reviews or inspections

Find out more

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