Credentialing That Protects Your Revenue
Credentialing That Protects Your Revenue
Specialty-focused physician credentialing and provider enrollment that helps protect reimbursement and prevent avoidable revenue delays. The ability to correctly credential all providers and all service locations makes all the difference—and it is a cornerstone of an effective billing process. By developing our own proprietary credentialing software, we are positioned to enhance the effectiveness of your billing process.
Payer credentialing and provider enrollment are critical components of an effective revenue cycle. Delayed, incomplete or inaccuarte credentialing can prevent claims from being paid correctly and create unnecessary revenue disruption.
APS Medical Billing provides comprehensive physician payer credentialing and provider enrollment services for pathology, laboratory and radiology practices, including hospital-based physician groups and multi-location organizations. Our experienced credentialing specialists manage the process from initial enrollment through ongoing maintenance, re-credentialing and payer revalidation.
Supported by our proprietary APS Credential 360 system, our team tracks payer requirements, provider documentation, application status, revalidations and expiring credentials to help keep providers properly enrolled and billing-ready.
Credentialing is not a one-time event. APS Credential 360 provides continuous oversight of the credentialing lifecycle, from initial provider review and payer enrollment through ongoing maintenance and revalidation.
Our experienced credentialing team combines specialty expertise with proprietary technology to proactively manage credentialing requirements and help reduce reimbursement disruptions.
Payer Enrollment & Credentialing — Coordinate new provider, group and applicable site enrollment with Medicare, Medicaid and commercial insurance plans.
Ongoing Maintenance & Revalidations — Track payer re-credentialing and revalidation requirements to help maintain active participation.
Expiring Document Tracking — Monitor licenses, insurance and other time-sensitive credentialing documentation.
Locum Tenens Credentialing Support — Help practices navigate credentialing and enrollment considerations associated with temporary physician coverage.
Proprietary Credentialing Technology — Centralize and track credentialing activity, outstanding requirements, deadlines and status.
Forensic Credentialing Review — Review existing carrier credentialing to identify enrollment gaps, inconsistencies or issues that may be affecting reimbursement.
Pathology & Laboratory Credentialing
Pathology practices often operate across hospitals, laboratories and multiple service locations, making accurate provider-to-group and provider-to-location enrollment especially important. APS helps pathology groups manage payer credentialing and enrollment as physicians join the practice, change locations or provide services across multiple facilities.
Radiology Credentialing
Radiology groups may have large physician rosters, multiple hospital and imaging locations, and complex professional-component billing arrangements. APS helps coordinate payer enrollment and ongoing credentialing requirements across providers, groups and service locations to support timely, accurate reimbursement.
APS’ experienced leadership team oversees all credentialing activity to ensure timeliness and accuracy throughout the process.
Forensic review of current credentialing.
We identify and close all gaps.
We maintain credentialing and revalidation requests.
If your current contract is not optimal, APS will review the contract with the payer. We will determine payment rates, credentialing requirements and claim submission. We will also examine each insurer’s claims-adjudication process to ensure compliance with contracted rates and appeal underpayments and erroneous denials. The result of all these efforts will ultimately be increased revenue for your practice as well as peace of mind knowing APS is in your corner.
For more than 65 years, pathology, laboratory and radiology practices have trusted APS to manage the complexities of reimbursement. Discover how our people, technology and specialty expertise can strengthen your revenue cycle and financial performance.
