SYNERGEN Health

A crucial component of any health organization is the management of Provider and Facility credentialing, monitoring, and maintenance. Credentialing is the process of reviewing a health professional’s credentials to determine if privileges to practice can be granted. Enrollment is the process of enrolling a health professional in contracts required by payors for reimbursement for medical services and/or products provided. Both credentialing and enrollment activities are critical to an organization’s financial performance.

Credentialing and Enrollment Overview

Credentialing is the process of reviewing healthcare practices and practitioners to determine if they meet the criteria for payor enrollment and medical privileging. The process involves collecting all current and background data, including accreditations, licensing, education, training, certifications, and work experiences.
Privileging is obtaining hospital or medical facility approval for a healthcare practitioner to perform procedures based on knowledge demonstration and competency.
Enrollment is the process of enrolling healthcare practices and practitioners in contracts required by payors for reimbursement for medical services and/or products provided.

Credentialing activities are critical to an organization’s financial performance. Let us ensure your credentialing privileges and practitioner enrollment process moves along efficiently and timely.

Proprietary Cloud-Based Software

Maintains credentialing compliance
Tracks expiration dates and renewals
Provides visibility into provider status

Avoid common mistakes as a result of the following challenges:

The absence of standardized requirements between payors adds complexity and time
Lack of available resources with regulatory and accreditation experience
Rules, regulations, laws and statutes vary across state and federal levels
Mistakes in credentialing and license expirations can result in financial losses

At SYNERGEN Health, we ease the burden of credentialing. Our 100+ combined years of credentialing experience in the medical field allow us to streamline the paperwork and eliminate any errors that can keep you from getting properly credentialed and contracted with payors and medical facilities.