Insurance & Network Contracting

Hospital Credentialing, Insurance Enrollment, Contract Negotiations

All of the above tasks used to be easy to do and required little more than filling out a 1-2 page application. Not so today!

Tougher national quality standards are being imposed on hospitals and payers. The result is that the credentialing and contracting processes are increasingly complex and require considerable work and knowledge.

When it comes to health plans, obtaining your credentialing is just the beginning. The contracts are lengthy and complex. Few of them tell you what you will be paid for your services. Can you negotiate rates? What is the process to do so? If you are not happy with the plan, can you withdraw easily? How quickly do they pay? All of these questions are important to you and the success of your practice.

At DR Management, we stay abreast of the changes and the requirements of each state and local hospitals.

We maintain a computer database that facilitates compiling the needed physician information and keeps it organized and readily available to complete ongoing credentialing.

DR Management, can help you negotiate your contracts and position you for success with the health care plans of your choice.

We can do any or all of the following tasks:

• Obtaining Hospital Privileges
• Collecting & Organizing Information
• (Required Data)
• Filling Out and Filing of All Forms for Hospital Privileges and Payer Contracts
• Negotiating Reimbursement Fees With Insurance Companies
• Monitoring and Updating Expiring Licenses, CMEs, Contracts, Addresses, etc.
• Maintaining Provider Numbers & Effective Dates
• Processing Status Changes
• (individual to group, salaried physician to solo practitioner, relocation, etc.)
• Managing All of the Details of Controlling the Critical Data of Your Practice