PROVIDER (PAYER) ENROLLMENT

Provider enrollment is a crucial step for healthcare providers to participate in private and governmental medical programs. Being successful in your enrollment ensures timely payment and being considered an in-network provider. Allowing you to provide the services your patients want and need as well as providing you with expected reimbursement. Our Provider Enrollment works with you and the insurance companies to ensure that your patients can see you and that all paperwork is completed correctly. Let us help you navigate the process and ensure you are properly covered to practice and generate revenue.

Onboarding

Your Provider/Plan Enrollment representative will work with you to acquire the necessary documents and information needed to enroll with payers. Documents typically involved include medical licenses, Drug Enforcement Administration (DEA) ID number, NPI's, malpractice insurance carrier and case information, board certification, education and work history, health documentation, even including activity or procedure logs, along with very personal information like a driver's license or other needed references such as from your peers. All information requested is needed for a successful and timely enrollment application! We adhere to HIPAA guidelines, state laws and ensure that your information stays secure during this process.

Timing & Focus

You should always focus on preparing the proper documentation requested timely and stay in direct communication with your Legacy representative to ensure your timeline is efficient and on track for your plan on providing care and services for your patients. Your Legacy representative will communicate items needed and updates throughout the process of enrollment. They are there to streamline your enrollment process and ensure your accurate billing revenue cycle is everything you expected and more!

Key Enrollments

Many common options to enroll in are:

Medicaid
Medicare
Aetna
Blue Cross Blue Shield
Cigna
Health Choice
United Health Care
Humana
Many Many More!

Onboarding Checklists

Applications
Documentations
Verifications
Revalidations
Research what healthcare plans you prefer to be a part of
Know what Contract you are signing for your reimbursement rates - Enrollment Fees

Maintenance

Collect, update, to include maintaining provider information and documentation. We verify the accuracy of information as needed too!
Maintenance of NPI and other applicable provider numbers
Maintenance of various payer portals or sites required
Complete reappointments in a timely manner for Medicare, Medicaid and other insurances chosen for accepting
Verify Group rosters, contracted plans, provider numbers
Your Provider Enrollment representative maintains a good rapport with Health Plan Representatives to avoid credentialing issues, and proactively will share knowledge about any payer updates with your billing staff and clinic staff. Along with timely follow-ups of your applications and reappointments