Credentialing Services Overview
For those physicians who don’t have the time or the staff able to handle the research needed to meet hospital or insurance credentialing demands, Peregrine can help. Whether it be working with the growing demands of Medicare or filling out paperwork and sending it off to a new insurance company or hospital, our team makes sure a practice’s information is kept up-to-date to meet the needs of healthcare today.
Peregrine will:
- Maintain a standardized credentialing application within our database and update application as necessary when new certifications, permits, or licenses are renewed
- Handle all re-credentialing issues that come into the practice, including those from managed care entities, hospitals, PHOs, IPAs, etc.
- Managed Care Organization Re-Credentialing Applications – Complete the necessary credentialing and re-credentialing applications for managed care entities
- Notify client in advance of licenses, permits, insurance and other credentialing items that are up for renewal
- Facility Appointments and Reappointments – Complete applications from facilities requiring reappointments. Peregrine completes the application, submits to the facility and follows up throughout the processing stages, fulfilling any additional requests. The application is considered complete once reappointment is approved by the Board
- Facility Requests – Provide facilities with renewed credentialing documents such as DEA, Physician Permits, and liability insurance. These items are submitted to the facilities once we receive the updated copies from client. Peregrine follows up to confirm receipt
- Demographic Changes – Contact managed care entities including Medicare and Medicaid when the client has any demographic changes
- Continuing Education Credits – Maintain a log of CME credits based on certificates provided by client. This data is requested by some managed care organizations as well as facilities
- Curriculum Vitae – Maintain current CV based on the information provided by client. This information is used for re-credentialing
- PECOS/Revalidation – Complete any necessary Medicare applications to comply with Medicare mandates and requirements
Special Projects
Should the practice add additional providers, Peregrine would contract, credential and link new provider to group where appropriate. If the practice terminates a relationship with a provider, Peregrine would “unlink” the provider from any group agreements in place.