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posted on Monday, November 04, 2013
The SCPHCA began offering Credentialing and Enrollment Services to member organizations in June 2013. In the first four months, we are pleased to say that this service has taken off like a rocket! To date, we are managing 5 contracts totaling 110 providers and are set up to do enrollments with 22 insurance payer plans.
SCPHCA is providing primary and secondary source verification, recertification, and licensure monitoring of information provided via application and supporting documentation for the purpose of credentialing new practitioners and re-credentialing existing practitioners. Verification services meet standards specified by the Bureau of Primary Care (PIN 2002-22) as well as those contained in NCQA and Joint Commission Accreditation for Healthcare Organizations credentialing guidelines relevant to health plan enrollment.
Taking the time to implement effective credentialing policies and procedures demonstrates a healthcare provider's commitment to excellence and to securing only the most qualified practitioners for its patients. The credentialing process consists of activities designed to collect relevant information that are evaluated as it relates to each individual physician licensures, training, experience, and competence from primary sources. The credentialing process and primary source verification are required by federal, state and/or other regulatory agencies to ensure patient safety.
Whether you are on-boarding a new physician, enrolling in a new health plan, or applying for FTCA coverage, the SCPHCA can provide you with the credentialing services that you need. The SCPHCA Credentialing and Enrollment Services will help streamline and reduce the time and labor intensive process for health centers.
For additional information or to schedule an appointment to discuss your credentialing needs, please contact William Feagin at 803-788-2778 or [email protected].