Credentialing Services

Integral Provider Solutions (IPS) specializes in comprehensive credentialing services designed to simplify the complex process of verifying and maintaining provider qualifications. With over 20 years of experience in healthcare revenue cycle management, we ensure that healthcare providers and facilities meet the necessary standards to deliver quality care while maintaining compliance with payer and regulatory requirements. Below is a detailed overview of the credentialing services offered by IPS:

1. Qualification Verification
   
   • Validate licenses, certifications, education, and training to ensure compliance with federal and state regulations.
   • Confirm board certifications, malpractice insurance, and DEA registrations.

1. Insurance Enrollment
   
   • Prepare and submit applications for participation in private, state, and federal insurance networks, including Medicaid and Medicare.
   • Serve as the primary point of contact with payers to expedite approvals.

1. Background and Compliance Checks
   
   • Conduct thorough background checks, including disciplinary actions, malpractice claims, and criminal history.
   • Ensure adherence to NCQA, URAC, and other regulatory standards.

1. Accreditation Guidance
   
   • Assist healthcare facilities in obtaining accreditations such as JCAHO or AAAHC.
   • Provide support for policy and procedure development to meet accrediting body standards.

1. Payer Network Inclusion
   
   • Facilitate facility enrollment in commercial and government insurance networks.
   • Ensure compliance with payer-specific requirements.

1. Ongoing Monitoring
   
   • Track license renewals, certifications, and insurance coverage to prevent interruptions.
   • Maintain up-to-date provider and facility records for audits and payer requirements.

1. Re-Application Services
   
   • Manage re-credentialing timelines to ensure continued network participation without delays.

1. Driver and Vehicle Verification
   
   • Validate driver qualifications, safety certifications, and compliance with state laws.
   • Ensure vehicles meet safety and insurance requirements for Non-Emergency Medical Transportation (NEMT) services.

1. Program-Specific Compliance
   
   • Provide assistance with credentialing for specialized programs like Movicare and Medicaid NEMT.

1. Experience and Expertise: With decades of industry knowledge, IPS offers unparalleled insight into payer requirements and best practices.
2. Efficiency and Accuracy: Our streamlined processes reduce administrative burdens, prevent delays, and enhance revenue cycle performance.
3. Custom Solutions: Tailored credentialing strategies to meet the unique needs of individual providers and healthcare facilities.

• Timely Reimbursements: Avoid delays in payer approvals and claims processing.
• Regulatory Compliance: Stay aligned with industry standards and mitigate compliance risks.
• Focus on Care: Let IPS handle the credentialing complexities while you concentrate on delivering exceptional patient care.

Integral Provider Solutions is your trusted partner for credentialing excellence. Together, we help healthcare providers and facilities achieve operational efficiency and sustained growth.