Credentialing & Payor Enrollment
Our team helps relieve the administrative burden that comes with credentialing medical staff, allowing you to focus on your business.
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. Our experienced team has processed over 1,500 applications for providers at 80 sites in eight states. The primary benefits of partnering with our credentialing includes:
- Reducing Administration – Managing diverse applications to ensure that the credentialing process advances efficiently, leading to improved provider satisfaction and more time dedicated to patient care.
- Diminishing Revenue Loss – Lowering the revenue loss related to delays in payor enrollment or privileging.
- Streamlining Processes – Including those associated with obtaining medical staff membership or clinical privileges at multiple organizations.
- Cost-Effective Services – Delivering highly efficient services and predictable cost management.
- Developing Custom Reports – Developing customized reports that allow providers and practice managers to easily track credentialing and payor enrollment approval dates.
- Subject Matter Expertise – Providing subject matter expertise in regulatory and accrediting requirements, which decreases compliance risk.
Key Services
Partner with medical staff offices of health systems, hospitals, ASCs, and other sites across the U.S. to provide credentialing services for physicians and allied health professionals initial appointment and reappointments.
Provide comprehensive payor enrollment services including CAQH maintenance, NPI registration and profile updating, payor recredentialing, network directory updates, provider/facility maintenance, and Medicare and Medicaid revalidation.
Provide extensive compliance management services, such as OIG/SAMS/State exclusion monitoring.
Conduct primary and secondary source verification for initial appointment and reappointment.
Develop and maintain CVO processes and systems that are compliant with various regulatory and/or certifying agencies such as TJC, AAAHC, OIG, and others.
Create easy-to-use reports to track licensing, DEA licenses, board certification, and other requirements.
Featured Team Members
“When we had some unexpected staffing changes in our credentialing department, the SMSC medical staff services team was able to jump in quickly to augment our remaining team – and we didn’t miss a beat. Since then, SMSC has helped us automate our credentialing processes, improve workflow, and substantially reduce our turnaround time for re-appointments.”
Geoff Lawton, COO, Radiology Imaging Associates