Credentialing & Payor Enrollment

Our team helps relieve the administration that comes with credentialing medical staff, allowing you to focus on your business.

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Experienced Medical Staff Support

Outsourcing these services to SMSC relieves the tremendous administrative burden associated with credentialing and privileging functions and allows you to focus on your core business: providing excellent patient care.

 

SMSC provides a full suite of medical staff support services, including expirable tracking and reporting, commercial and governmental payor enrollment services, primary source verification, facility privileging application support, and compliance consulting.


Key Benefits

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Reducing Administration

Reducing the administrative burden associated with complex application procedures, leading to improved provider satisfaction and more time dedicated to patient care.

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Diminishing Revenue Loss

Lowering the revenue loss related to delays in payor enrollment or privileging.

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Streamlining Processes

Including those associated with obtaining medical staff membership or clinical privileges at multiple organizations.

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Cost-Effective Services

Delivering highly efficient services and predictable cost management.

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Developing Custom Technology

Developing customized dashboards that allow providers and practice managers to easily track and report requirements for credentialing, privileging, ongoing professional performance evaluation (OPPE), and accreditation.

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Subject Matter Expertise

Providing subject matter expertise in regulatory and accrediting requirements, which decreases compliance risk.


Key Services

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Partner with medical staff offices of health systems, hospitals, ASCs, and other sites across the U.S. to provide application and privileging support for both initial and reappointments.

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Provide comprehensive payor enrollment services, including CAQH maintenance, revalidation, provider/facility maintenance, and Medicare and Medicaid revalidation.

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Provide extensive compliance management services, such as OIG/SAMS/State exclusion monitoring, tracking board of licensure requirements, and administering medical staff bylaws.

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Leverage relationships with a wide range of commercial and governmental payors to ensure efficient processes.

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Conduct primary and secondary source verification for initial and reappointment.

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Develop and maintain procedures and systems compliant with various regulatory and certifying agencies such as AAAHC, OIG, boards of licensure, and others.

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Develop efficient processes and coordination among essential departments, including recruiting, revenue cycle, and others.

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Create easy-to-use provider reports to track licensing and other requirements.

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Featured Team Members

Roseann Napoleone

CPCS, CPMSM – Manager, Credentialing & Payor Enrollment

Expand Your Medical Staffing Services