HEALTH PLAN AUDITS

Insurance plans change and provider turnover is part of the business. CredentialingOne provides auditing services for larger facilities to ensure providers are participating in the correct plans and your provider roster is current.

An annual audit of plan participation is critical for front desk collections. It’s important to understand the plans your practice and providers participate in when collecting the appropriate co-pay or deductible. 

There are many potential changes to monitor, including: 

  • Payer contracts may require practices to notify them within 30 days of a provider’s termination (resignation, retirement, etc.), but many practices forget to do so. 
  • As new plans are added by a payer, credentialed providers may not realize they need to opt-in to participate. 
  • Payer contracts may require providers to opt-out of plans or they will automatically be included in them. 

We can keep track of all these moving parts for you. Make CredentialingOne your health plan audit service! 

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