Credentialing

Credentialing you can trust. Convenience you can rely on. When you need essential credentialing data, and you need it immediately, Simplexmed is here to help you. As a leading source, our credentialing services provide comprehensive information and documentation. Our trusted and comprehensive data meet selected credentialing requirements of the Centers for Medicare and Medicaid Services (CMS). Credentialing comes before even bill your first claim is submitted. Failing to manage the credentialing and contracting process will cause a loss in revenue. To most, credentialing is a long drawn out process, filled with completing applications, waiting on hold for provider relation representatives, and gathering lots of documentation. No worries! Here’s how we can help!
Credentialing Services Include: Enrollment in commercial insurance carriers of your choice. Medicare enrollment (PECOS) and state specific Medicaid for all 50 states. CAQH registration and completions Type 1 and 2 NPI applications. Customized reporting to keep you updated on application status. Follow up with all insurance carriers until application approval. Access to all provider numbers and effective dates. Ongoing maintenance of CAQH (every 120 days), Resolution of all credentialing related billing services.

credential
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Revenue Optimizer (RO)

We will optimize your revenue through practice web-portal development and online marketing, payout analysis.

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Claim Preparation

Error-free claim preparation and validation based on information provided by the practice.

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Elec/Paper Claim Submission

Claims can be submitted either electronically or via paper mail where required.

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Credentialing Services

When you need essential credentialing data, and you need it immediately, Simplexmed is here to help you.

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Elec Data Interchange (EDI)

End-to-end encrypted data transfer between payers and providers along with electronic fund transfer (EFT).

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Patient Services

Patient calls, itemized electronic and paper statements, and toll-free patient helpdesk.

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Reporting

Get all the relevant reports when you need them. Easy access to all reports with a single click.

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Coding Services

Provide services in implementation of ICD-10 & CPT codes, help in diagnosis and procedures.

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Payment Posting

Faster and accurate claim submission results in timely payment posting to the providers.

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A/R Management

Timely follow-up with the payers to assure timely payments to the provider.

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Denial Management

Minimal denials with active web based charge entry system.

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Meaningful Use

Meaningful use: is using (MU certified) electronic health record (EHR) technology.