Credentialing, Payor Enrollment, Consulting and Primary Verification Sources

Advocating for doctors, practices, healthcare providers, hospitals, and outpatient offices.

The philosophy of Inquire Credentialing Management Solutions is to alleviate the administrative burden of healthcare practices and doctors to ensure they can attend to the clinical needs of their patients.

The clients we serve are individuals and healthcare groups that manage the credentialing and payor enrollment of the doctors. The clients are offered an opportunity of a free consultation with an outline of a project plan to assist in addressing immediate concerns to improve the credentialing timeframe, reduce credentialing related denials, and evaluate the current team members overseeing credentialing.

With a National Certification and over 17 years of management experience, we bring every experience to assist in any credentialing challenge.

Contact Us

Credentialingmgmtsolutions@gmail.com
(240) 605-6412

Areas of Practice

Payor Enrollment

Delegated Agreements

Primary Source Verification

Review policies and procedures to ensure it aligns with current credentialing standards mandated by NCQA and URAC.

Audit & Risk Management

  • Obtaining doctor applications and supplemental documents

  • Preparing and Submitting doctor applications

  • Following up on submitted applications

  • Obtaining approvals, effective dates, and recred dates

  • NPDB Reports

  • State License

  • DEA/CDS

  • Board Certification

  • Residency Verification

  • CAQH

  • Exclusion Checks (OIG/SAM/STATE/FEDERAL)

  • Social Security Death Master

  • Peer Reviews

  • Patient Complaints

  • Implement Credentialing Policies and Procedures

  • Implementation of Credentialing Committee with Selection of Doctors

  • Credentialing Committee Charter

  • Maintain Annual Audits

  • Solicit Payor Delegation Agreements

  • Oversee and Manage Payor Delegated Audits

  • Contract Review and Negotiation

Contact Us to

  • Reduce payor credentialing timeframes

  • Increase doctor revenue

  • Implement Delegated Credentialing

  • Improve patient experience

  • Assist in NCQA or URAC Credentialing Certification