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Provider needs to validate its qualifications to ensure that they are a perfect fit to deliver care to the patients. If they fail to do so, they won’t benefit from the insurance companies. Plutus Health Inc. helps steer the credentialing process and get providers & practices in-network with insurance plans.

Plutus Health Inc. is an in-network provider with all the possible payers and plans. We preserve the documents of the providers and practices with integrity in our advanced credentialing tool and keep it transparent with our clients to see the status of their applications.

Below is the type of work managed in credentialing for all providers in all states:

  • Group Credentialing
  • Provider Credentialing
  • Re-Credentialing
  • Provider CAQH Maintenance
  • Demographic Updates

We work with the majority of the payers regularly and have a strong relationship with the insurance representatives. We also have strong communication lines with the payers. Our experts involved in credentialing always ensure that there are no gaps in filing and submitting the application on time.

Top 5 Steps Involved in Our Credentialing Process:

  • Checklist: We have our own robust credentialing checklist, we gather all the information from the practice as per our checklists.
  • Source Validation: Once the checklist is received, then we verify practitioner/ facility information using our automated eligibility verification software.
  • CAQH Maintenance: We ensure all the required information and documents are uploaded to the CAQH profile.
  • Top Payers: Identify top payers in the given state and apply in the payer-specific format.
  • Follow-up With Payers: Timely follow-up on submitted application requests.

Our Credentialing Tool:

We do all credentialing activities in one tool and track submitted applications for all work types. One glance at our credentialing management dashboard helps understand the status of the applications submitted. Our credentialing expertise will help you along every step of the way. Using our tool, we can expedite and efficiently carry out complete applications, subsequent follow-ups, renewals (Re-credentialing), and generate the reports based on the need.

Enrollment Process:

We do below Enrollments as well along with credentialing.

  • EDI Enrollment
  • ERA Enrollment
  • EFT Enrollment

Benefits of Provider Credentialing and Enrollment Services:

  • Keep your data up-to-date with payers.
  • Process faster payments from insurance and get more patient referrals.
  • Build relationships with different payers.
  • Receive real-time status of credentialing and enrollment transactions.

Plutus Health Inc. is your one-stop destination for all automation-enabled medical RCM services.

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