Claims Submission, Payment Posting, Denial Management, Patient Billing, Compliance and Financial Reporting.

Our team helps healthcare providers to navigate the complex world of insurance credentialing and enrollment, ensuring that they are properly enrolled and credentialed with payers and can receive proper reimbursement for their services. Credentialing services include the following:

• Provider Enrollment: assist healthcare providers in enrolling with insurance companies and other payers to become credentialed providers. Completing and submitting enrollment forms, necessary documentation, and following up with payers to ensure timely enrollment.
• Provider Credentialing: help healthcare providers maintain their credentials by verifying their education, training, licensure, and other qualifications with insurance companies and other payers. Submitting credentialing applications, supporting documentation, and tracking the status of the credentialing process.
• Provider Revalidation: assist healthcare providers in revalidating their credentials with insurance companies and other payers, ensuring that their credentials remain up to date and valid.
• Provider Network Participation: help healthcare providers participate in insurance networks, allowing them to expand their patient base and increase revenue. Submitting participation applications and managing network participation requirements.

Adelfi’s Practice Management Consultants assist our healthcare providers with business development strategies and workflow development. Our consultants collaborate with your medical practice administrators.

In addition to having over 25 years of experience in the industry, we pride ourselves on offering continuous education and training, advanced technology and tools for coding, compliance, auditing, and quality assurance to our team.