Credentialing

New Provider

  • Must credential with the insurance carriers you plan to accept for
    reimbursements
  • RTMC can help meet these credentialing needs

Adding Additional/New Providers

  • Each provider will need to be added and credentialed to the group contacts
  • RTMC can help meet these credentialing needs

Adding New Insurance Companies

  • Must credential when adding/accepting new insurance payers.
  • RTMC can help meet these credentialing needs

NPI Verification

  • Primary Source verification for providers to NCQA or Joint Commission
    Standards.

Provider Enrollment

  • To complete the credentialing process for the healthcare providers, becoming an
    “in Network” provider

CAQH

  • Create, Validate and Maintain providers CAQH profiles.
  • Make sure documents are up to date.
  • Make necessary changes as needed.
  • Re-Attest the file on a regular basis. Re-Credential with Health Plans as needed.

Please allow 90 to 120 days for completion.

 

Credentialing Packages

Package 1 (ala carte)

Less than 5 payers

With billing service – $175 per payer

Without billing service – $350 per payer

Package 2

5 payers (including CAQH)

With billing service – $775

Without billing service – $1550

Package 3

10 payers (including CAQH)

With billing service – $1500

Without billing service – $3000