Efficient. Thorough. Proven.
Our clients typically do not have the technology, expertise or staff needed to successfully manage the Credentialing Life Cycle. They turn to STAT for ways to improve revenue, reduce costs and improve outcomes. STAT manages the entire credentialing life cycle for its clients, handling the entire process with the exception of signing documents. Whether you are looking for physician credentialing, nurse credentialing, medical staff credentialing, hospital credentialing, or insurance credentialing, our experts can efficiently and effectively cater to all your credentialing needs. We have a proven record of removing barriers, increasing revenue and reducing denials associated with our detailed and precise credentialing process. Our approach to partnering with our clients is to do the right thing, at the right time, and for the right price. The result? Clients for life!
Our certified provider credentialing specialists work with healthcare organizations throughout the five stages of the Business Life Cycle. During the growth of a healthcare organization, it will go through each of the five stages of the business life cycle listed below, encountering different challenges that require a different mix of services offered by STAT. For instance, while the services listed in the growing and expanding stages are the same, the mix of services our clients use, and the degree to which each service is used, may be different.
During our consultation with you, we will help you identify the answers to the following questions:
What stage of the business life cycle is your healthcare organization in?
What STAT services do you need?
Stage 1: Concept
The development or concept stage is the beginning of the business life cycle. At this stage, the client is brainstorming ideas about the business they want to start. It requires research, gathering feedback and, in some cases, market testing to determine if the idea is worth pursuing as a new business.
Some Challenges:
- New business will be profitable?
- Is there a market?
- Structure of the business?
- Resources needed to be successful?
STAT Services you may need:
- Research
- Consultation
Stage 2: Startup
During the startup stage, our clients have decided their business idea is worth pursuing and have set up the organization. They have a clear understanding of the services and/or products that they will offer and have decided to open their doors. During this stage, our clients may need to tweak their offering to ensure they are profitable, while also meeting the needs of their patient’s.
Some Challenges:
- Market presence established?
- Patient and referral base established?
- Is there sufficient cash flow?
- Do you stay out of network or become contracted?
STAT Services you may need:
- Payor Enrollment (commercial, Medicare, Medicaid)
- Appeals
- CAQH – New Applications and/or Update Applications & Quarterly Attestations
- NPI Application(s) and/or update NPI profile(s)
- Hospital privileging (new)
- Licensing (new)
- FCVS Establishment
- DEA/CPS (new)
Stage 3: Growing (or Surviving)
During this stage, our clients are either in a growing or a surviving phase. Their businesses consistently generate revenue through the addition of new patients or providers, and typically some competition exists. They are either operating at a net loss, or a healthy profit. This is when they look to improve their models, systems, revenue and operations. They look to focus on their core competencies to control costs.
Some Challenges:
- Management team effective?
- Impact of market competition?
- Do you have solid referrals?
- Revenue being maximized?
- Increase in number of denials?
- Addition of new products, services, or providers?
STAT Services you may need:
- Payor Enrollment (commercial, Medicare, Medicaid)
- Appeals
- CAQH – New Applications and/or Update Applications & Quarterly Attestations
- NPI Application(s) and/or update NPI profile(s)
- Adding new service location(s)
- Re-credentialing providers & managing re-credentialing dates
- Revalidating Medicare and Medicaid
- Obtaining copies of Contracts & Fee Schedules
- Managing contracts & Fee Schedules
- Fee schedule negotiations
- Updating Network Directories
- Removing Reassignments
- Hospital privileging (new/renewal)
- Licensing (new/renewal)
- FCVS Establishment
- DEA/CPS (new/renewal)
- Managing and reporting expirables, including re-credentialing dates, hospital privileges, licenses & DEA
Stage 4: Expanding (Rapid Growth)
During the expansion stage, our clients have a thriving company and have established themselves in the industry. They are now ready to expand into new markets whether local, regional or national. They need new sources of revenue and cash flow to finance their expansion.
Some Challenges:
- Increased competition?
- Entering new and different markets?
- Addition of new products, services, or providers?
- Expanding existing business? Adding locations?
- Organic vs. inorganic growth?
STAT Services you may need:
- Payor Enrollment (commercial, Medicare, Medicaid)
- Appeals
- CAQH – New Applications and/or Update Applications & Quarterly Attestations
- NPI Application(s) and/or update NPI profile(s)
- Adding new service location(s)
- Re-credentialing providers & managing re-credentialing dates
- Revalidating Medicare and Medicaid
- Obtaining copies of Contracts & Fee Schedules
- Managing contracts & Fee Schedules
- Fee schedule negotiations
- Updating Network Directories
- Removing Reassignments
- Hospital privileging (new/renewal)
- Licensing (new/renewal)
- FCVS Establishment
- DEA/CPS (new/renewal)
- Managing and reporting expirables, including re-credentialing dates, hospital privileges, licenses & DEA
Stage 5: Established (Maturity)
After successfully expanding (locally, regionally or nationally), our client businesses are at the top of their industry, established and typically stable. They have a dominant presence in the market(s) they serve and the growth rate of the business has slowed.
Some Challenges:
- Increased competition?
- Entering new markets?
- Addition of new products, services, or providers?
- Expanding, and maintaining, existing business?
STAT Services you may need:
- Re-credentialing
- Quarterly CAQH Re-attestations
- Updating NPI Profiles
- Revalidating Medicare/Medicaid
- Updating Network Directories
- Removing Reassignments
- Managing Contracts & Fee Schedules
- Obtaining Copies of Contracts & Fee Schedules
- Fee Schedule Renegotiations
- Hospital privileging (renewal)
- Licensing (renewal)
- FCVS Establishment
- Terminating Contracts
- DEA/CPS (renewal)
- Managing and reporting expirables, including re-credentialing dates, hospital privileges, licenses & DEA
As you grow your healthcare business, you will need a reliable and thorough credentialing partner so that you can focus on the day-to-day operations and growth of your business. We look forward to speaking with you about your specific needs.