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MD-CRED SERVICES
Home
About Us
Services
  • Credentialing
  • Licensing
  • Additional Services
GET STARTED
Contact Us
RESOURCES
  • Resources
  • BLOG
  • E-Course
More
  • Home
  • About Us
  • Services
    • Credentialing
    • Licensing
    • Additional Services
  • GET STARTED
  • Contact Us
  • RESOURCES
    • Resources
    • BLOG
    • E-Course

  • Home
  • About Us
  • Services
    • Credentialing
    • Licensing
    • Additional Services
  • GET STARTED
  • Contact Us
  • RESOURCES
    • Resources
    • BLOG
    • E-Course

PRIMARY SOURCE VERIFICATION (PSV)

* State Licensure & Sanction History & Details

* Board Certifications

* FSMB/ ECFMG/ AMA/AOA Profile

* DEA and State Drug Certificate

* Education & Post-graduate Training

* Death Master File

* NPI/ NPDB

* Malpractice Insurance Certificate/ Claims History & Details

* Attestation

* Hospital Affiliation/ Work History

* Background Checks/ Peer Reference

* Medicare/Medicaid Sanctions/OIG/SAMS

ON-GOING MAINTENANCE

SANCTION MONITORING

* License Sanction Publication

* Office of Inspector General (OIG) Exclusion

* System for Award Management (SAM)

* State Medicaid Sanction / Exclusion

* Medicare Opt-Out

* Death Master File


EXPIRABLES

Tracking and Updating insures providers non-static credentials are kept current in between credentialing cycles.

* State License

* DEA

* Board Certification

* State Drug Certificate

* Malpractice Insurance Certificate

* Fluoroscopy & Radiography Certificate


APPLICATION MANAGEMENT

Preparation and send out application packets and or CAQH update notification to Providers on behalf of our Clients at both Initial Credentialing and Recredentialing.

* Programming and Pre-population

* State Standard / Custom Application

* Recredentialing Due Date Tracking

* Application + Addendum Send Out and Follow Up

CREDENTIALING

PAYER ENROLLMENT

Initial Payer Application & Re-credentialing

MDCS serves as the liaison between the providers and payors until the credentialing process is completed. We work with providers of all specialties nationwide and can assist with credentialing for any health plan for example: Medicare, Medicaid, BCBS, Aetna, Cigna and more. 

Out Of Network Enrollment

Our team helps with out of network (OON) enrollments, whether you choose to stay out of network with a payor(s) or because the network panel is closed. OON will allow you to start receiving out of network payments.

Contract Negotiation

Your reimbursement rate is too low, no problem! Let us know and we will renegotiate on your behalf. 

Demographic update

 Whether it is a simple address, bank account update, ERA & EFT set up, we can help you. We help with all simple and complex changes with all payors. 

Panel Analysis/Network Research

The insurance network panel status change constantly and when starting or expanding a new practice, providers are frequently unaware of the panel status in their local market area. MDCS will perform a custom insurance payer analysis and determine which insurance panels are accepting new providers in your specialty and in your local market.

NPI/CAQH Setup & Maintenance

We maintain and keep your CAQH and NPI profiles up to date, making sure all your information is accurately profiled and compliant. Keeping your NPI and CAQH profiles is a necessity in today’s healthcare environment as most payors are getting the documents from CAQH.


HOSPITAL APPOINTMENT

Initial Appointment / Re-Appointment Application

MDCS can assist all Providers with their Hospital Appointments and Reappointments application process. Just tell us which hospital you are interested in and well do the rest. 

book a consult

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