Optimizing the Healthcare Credentialing Process for Enhanced Efficiency and Compliance
Decrease in AR Days
Lower Cost Collections
Increase Net Patient Revenue
Jump in Collections
Trusted by Premier Healthcare Institutions
Experience
Alpha Core Healthcare
Revenue Cycle Management
Revenue Cycle Management (RCM) refers to the process healthcare organizations use to manage the financial aspects of patient care. It involves the end-to-end process of capturing, managing, and collecting patient service revenue. RCM includes everything from patient scheduling and registration to claims submission and payment collection.
Credentialing and Enrollment Services
Lab credentialing and enrollments are essential processes for ensuring that laboratories can participate in insurance networks and are reimbursed for services rendered.
Patient/Client Centric Enablement
Patient/Client Centric Enablement refers to healthcare strategies and technologies that prioritize the needs and experiences of patients or clients throughout their care journey. The goal is to improve satisfaction, outcomes, and engagement by putting the patient at the center of the healthcare process.
Billing Assessments & Compliance
Billing assessments involve evaluating an organization’s billing practices to ensure accuracy, efficiency, and adherence to financial regulations. Compliance ensures that billing practices follow legal, regulatory, and industry standards.
Why Credentialing is Essential
Credentialing is a critical process that verifies a healthcare provider’s qualifications, certifications, and professional background. Proper credentialing:
- Ensures eligibility for insurance reimbursements.
- Reduces claim denials and delays.
- Maintains compliance with Medicare, Medicaid, and commercial payers.
- Enhances patient trust and healthcare credibility.
Additional Services Offered apart from Credentialing & Enrollment
CAQH Setup/Maintenance:
Complete creation and ongoing updates of provider profiles in the Council for Affordable Quality Healthcare database, ensuring your information remains current for all participating payers.
Business Entity License:
Comprehensive management of your facility’s licensure requirements, from initial application to renewal, ensuring continuous compliance with state regulations.
Professional License:
End-to-end processing of individual provider licenses across all relevant states, including initial applications, renewals, and compliance monitoring.
DEA Registration:
Streamlined application and renewal process for Drug Enforcement Administration registration, enabling providers to legally prescribe controlled substances.
CDS Registration:
Complete management of Controlled Dangerous Substance registration requirements, coordinated with DEA registration for comprehensive prescribing authority.
License Research-Business/Professional:
Thorough investigation of licensing requirements across multiple states for both facilities and individual providers, tailored to your specific practice needs.
NPI Creation/Maintenance:
Establishment and management of National Provider Identifiers for both individuals and organizations, ensuring proper linkage and compliance with HIPAA requirements.
Demographic Updates:
Systematic distribution of provider and practice information changes across all relevant payers and databases, maintaining data consistency.
Network Research for Payer Enrollment:
Strategic analysis of insurance networks to identify optimal enrollment opportunities based on your patient demographics and service offerings.
Submitted Application Follow-up:
Proactive monitoring and advocacy for all submitted applications, reducing processing times and addressing potential issues before they cause delays.
EFT Enrollment:
Complete setup and maintenance of Electronic Funds Transfer arrangements with all payers, streamlining your revenue cycle and accelerating payment receipt.
Re-Credentialing:
Comprehensive management of periodic re-credentialing requirements, preventing coverage gaps and ensuring continuous network participation.
CLIA Waiver:
Expert handling of Clinical Laboratory Improvement Amendments waiver applications and renewals, allowing your facility to perform approved point-of-care testing.
Industry Segment
Hospital Billing Services
Efficient and accurate hospital billing services to streamline revenue cycle management. Maximize reimbursements with our expert solutions.
Pharmacy Billing Services
Optimize your pharmacy’s revenue with seamless billing solutions. Accurate claims, faster reimbursements!
Nursing Care Facilities
Compassionate and professional care for your loved ones. Ensuring comfort, dignity, and well-being 24/7.
Medical Equipment Providers
Reliable medical equipment for better care. Quality products, fast delivery, and exceptional service!
Clinical Laboratories
Accurate testing, fast results. Trusted diagnostics for better patient care.
Physician Practice Groups
Streamlined operations, enhanced patient care. Supporting physician groups with expert solutions.
Outpatient Surgical Centers
Advanced surgical care with minimal downtime. Safe, efficient, and patient-focused procedures.
Tele Radiology/Telehealth
Remote care, real-time diagnostics. Expert telehealth and teleradiology services anytime, anywhere.
Struggling with an Increasing Backlog of
Claims and Upcoming Deadlines?
We’re here to assist with that as well.
Request a free, no-obligation quote for enrolling your providers.
Why Choose Alpha Core ?
Discover innovative solutions customized to meet your specific requirements
Proven Expertise
Alpha Core brings extensive industry knowledge and experience, ensuring high-quality solutions tailored to client needs.
Innovative Solutions
Constantly evolving, Alpha Core offers cutting-edge technologies and strategies to optimize operations and drive results.
Scalable Approach
Their solutions are designed to grow with your business, providing flexibility to meet changing demands and increasing efficiency.
Data-Driven Insights
With a strong emphasis on analytics, Alpha Core helps organizations make informed decisions that boost performance and profitability.
Reliable Support
Alpha Core offers robust customer service and ongoing support, ensuring smooth implementation and continued success.
Specialities We Enroll For
Laboratory
Durable Medical Equipment
OBGYN
Urology
Physical Therapy
Cardiology
Orthopedic
Sleep
Medicine
Chiropractic
Internal Medicine
Radiology
Behavioral
Health
Anesthesiology
Surgery
Rehab Billing
Customers Experience
“The credentialing process was much quicker and more straightforward than I expected. The team handled everything from documentation submission to verification, and I didn’t have to follow up constantly. It was a smooth experience.”
“Accuracy in billing is critical, and Alpha Core Healthcare has helped us drastically reduce errors. They have an expert team that stays up-to-date on insurance policies and billing codes, ensuring that claims are submitted correctly the first time. As a result, we’ve seen a significant reduction in denied claims and faster reimbursements.”
“I was really impressed by the customer service offered during the credentialing process. The team was responsive, professional, and always ready to answer any questions. They made the process feel less daunting and ensured everything was handled on time.”
“Accurate billing is essential, and Alpha Core Healthcare has been instrumental in minimizing errors. Their expert team stays updated on the latest insurance policies and billing codes, ensuring claims are submitted correctly the first time. This has led to fewer denied claims and significantly faster reimbursements.”
Connect With Us
- hello@alphacorehealthcare.com
- (302) 304-8686
- 3524 Silverside Rd, Wilmington, DE 19810, United States
Services
Contact Us
- hello@alphacorehealthcare.com
- (302) 304-8686
- 3524 Silverside Rd, Wilmington, DE 19810, United States
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