Health Care Credentialing Services

With proper support and training, you can develop an effective credentialing process to improve your cash flow and positively impact your entire health care organization.

Together we can reduce the frustration of credentialing — and help you get paid faster.

What’s on your mind?

  • Understanding how to streamline the complex credentialing process
  • Standardizing your approach for verifying the professional qualifications of licensed medical professionals
  • Learning how health care institutions and insurance networks conduct their own credentialing
  • Easing the challenges of the credentialing process
  • Improving your cash flow

Create opportunities with CLA

We use a holistic approach to understand all the facets of your business. We understand that addressing one issue within your credentialing process may impact other elements of your business, so we offer training and support to meet your specific needs. Many of CLA’s consulting professionals have firsthand experience working in health care organizations, so they know the industry well — right down to the complexities of the insurance companies you work with each and every day.

Credentialing support services

  • Develop provider/payer matrix for tracking purposes
  • Review and develop internal standard operating procedures for credentialing
  • Evaluate process for credentialing new providers with in-network carriers
  • Assess method for medical staff reappointments
  • Provide guidance through National Provider Identifier individual registrations (for newly licensed providers)
  • Verify current roster of providers with each in-network carrier
  • Review current provider files to ensure accuracy
  • Monitor licenses and other documents for upcoming expiration and renewal dates
  • Assist with Minnesota Credentialing Collaborative (MCC) database maintenance for enrolled providers
  • Provide support for Council for Affordable Quality Healthcare (CAQH) database maintenance for enrolled providers (includes annual attestations)
  • Assist with Provider Enrollment, Chain, and Ownership System (PECOS) maintenance for enrolled providers
  • Review ongoing re-credentialing and re-validation requests for in-network carriers
  • Add or remove locations and demographic updates with in-network carriers
  • Assist in writing corrective action plans regarding credentialing, as needed