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SCPHCA Announces Credentialing and Enrollment Services

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SCPHCA Announces New Credentialing and Enrollment Services

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posted on Tuesday, June 11, 2013

The South Carolina Primary Health Care Association (SCPHCA) is committed to providing member organizations with services that increase flexibility in the allocation of center resources.  In response to numerous requests, the SCPHCA is now offering Credentialing and Enrollment Services.

Community Health Centers are required to thoroughly assess the credentials of all licensed or certified health care practitioners who deliver patient services at any of their sites.  This requirement applies to all Health Center practitioners - employed, contracted, locum tenens or volunteer.  An effective credentialing program, however, requires a knowledgeable staff which understands that Center practitioners cannot generate revenue unless they are properly credentialed.Provider credentialing is the first step in revenuecycle development. Claims cannot be filed until the insurance carrier approves the provider.

SCPHCA's Credentialing Service consolidates all credential verification responsibilities by offering a variety of credentialing related programs including:

  • Credentialing and Re-Credentialing Practitioners
  • Tracking Expiration Dates of Credentials
  • Enrolling Practitioners in Health Insurance Plans
  • Addressing Documentation Requests by Payers
  • Ensuring Compliance with FTCA Requirements
  • Reviewing Credentialing Policies And Procedures

 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. 

SCPHCA Credentialing and Enrollment Services utilize credentialing software and employs dedicated credentialing staff. Our credentialing is completed accurately and efficiently. Our process is to collect the required professional and personal information for each provider. This information is entered into an electronic format with all pertinent supporting documents scanned into the database. These include: licenses, DEA certifications, curricula vita, professional training certifications, CEU certificates and other documents that might be required. This is done through primary and secondary source verification.

For more information on Credentialing and Enrollment, please contact William Feagin, Director of Revenue Maximization, at 803-788-2778 or [email protected]  You can also reach the Credentialing Department at [email protected] 

The SCPHCA is the membership organization that represents all of South Carolina's community health centers, which are an integral part of the local primary health care systems in our state.  In 2012, the 19 community health centers provided affordable, community-based, and coordinated preventive and primary health care services to over 324,000 patients statewide.  Community health centers, located in 42 of the state's 46 counties, provide high quality primary, dental and behavioral health services to all patients while reducing inappropriate Emergency Room usage, overall health care costs, racial and ethnic health disparities, and other barriers to care.  

 

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