CREDENTIALING MONITORING & MAINTENANCE

CredentialingOne can build a custom maintenance and monitoring program that works with your credentialing policies. Maintenance and monitoring are part of the credentialing life cycle – if providers’ credentials and documentation are not maintained and expire, they will be deactivated by payers. When deactivation happens, claims get denied. CredentialingOne is here to help.

Credentialing Maintenance Compliance
  • CAQH Quarterly Attestations: Every 120 days we will reattest the provider – we also upload new documents as they are set to expire.
  • Monitoring Expirables: Email and text alerts to the provider when documents are nearing expiration starting at 120 days prior to expiring. We also provide you with a master report indicating providers with expiring documents at 120, 90, 60, and 30 days.
  • Re-Credentialing and Re-Validation: Commercial and Government Payers (Medicare, Medicaid, TriCare)
  • Demographic Updates: Address, phone, name change
  • Directory Updates: Medicare payers in particular request providers to verify their demographic information every 6 to 12 months.
  • NPDB (National Practitioner Data Bank)
  • SAM and OIG Queries
  • Primary Source Verification
  • Practice Services: Radiology and CLIA certifications
  • Malpractice
  • CE Credits

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