Medical Practice Administrative Tasks
Medical Practice Administrative Tasks vary depending on the client’s needs and requests but most often include obtaining patient eligibility and benefits, provider credentialing, and contracting the provider with requested insurance companies.
Eligibility and Patient Benefits
ANO Revenue Cycle Management utilizes several different platforms to obtain patient’s benefits and eligibility. This task will be run on a daily basis per each client’s contract. The benefit and eligibility information will be made available to each client as soon as it is received.
Provider Credentialing
ANO Revenue Cycle Management has experience with credentialing individual providers and groups with all the major insurance companies. This includes Medicare, Medicaid, Blue Cross Blue Shield, United Health Care, Humana, Aetna and many others. In addition to completing the initial credentialing ANO-RCM performs all of the re-credentialing that is required by the insurance carriers for our clients. ANO-RCM also makes sure our clients CAQH* data is updated and re-attested every quarter.
CAQH – Council for Affordable Quality Healthcare, Inc. This is a centralized credentialing site that many of the large insurance companies utilize when credentialing providers.
Insurance Company Contracting
ANO Revenue Cycle Management will establish new contracts once the credentialing process is complete. ANO-RCM will then negotiate rates for the new contracts in addition ANO-RCM will re-negotiate rates for any current contracts our clients may hold. Most insurance contracts auto-renew on a yearly basis, ANO-RCM can monitor our clients contracts to know when the window for re-negotiation is valid.