Custom Credentialing Services – Not all credentialing services and payer enrollment projects are alike. Many times, organizations require temporary or limited professional assistance in their pursuit of establishing or maintaining excellence in the credentialing and provider enrollment lifecycle. As a cloud-based credentialing solutions provider, Newport is uniquely positioned to assist healthcare providers with a custom credentialing services project plan to meet short-term or long-term objectives. Below are a few examples of custom credentialing services project types we have initiated on behalf of our clients.
- Medicare and Medicaid Enrollment Services
- Out-of-State Medicaid Enrollment Services
- Tax Identification Number (TIN) consolidation Services
- Payer “Change-To” Services
- Short Term or Temporary Provider Enrollment Services
Custom Credentialing Services
The credentialing and provider enrollment lifecycle contains many operational pieces which can, at certain times, exhaust the resources of even the best-run credentialing team. As a recognized leader in credentialing and provider enrollment, healthcare providers of all sizes look to Newport for assistance in implementing short term or temporary credentialing projects and other credentialing services.
The University of Pennsylvania Health System (Penn Medicine) is a world-renowned academic medical center with nearly 2,000 physicians between its primary care network and faculty practice plan. Like many faculty practice plans and physician organizations that have evolved over the years, Penn Medicine had created and maintained a large number of tax IDs. Greater than 30 different tax IDs were in use with all of the revenue ultimately being owned by the Trustees of the University of Pennsylvania. With the significant increase in Electronic Medical Record (EMR) integration along with increasing regulatory requirements focusing on quality (Meaningful Use, Value Based Modifier, etc. ), the existing structure no longer worked. Reporting patient services under different tax ID’s did not properly reflect Penn Medicine’s integrated approach to the care they provide their patients.
Penn Medicine was faced with the enormous undertaking of paring down its faculty practice plan tax ID numbers from 32 to one and needed additional and experienced resources to complete the task within the desired timeframe. Penn Medicine partnered with Newport Credentialing Solutions to manage and complete the task.
Familiar with Newport and its reputation for excellence in provider enrollment and credentialing services, the Senior Director of Patient Accounting at Penn Medicine, Steven Honeywell, enlisted Newport’s services.
Newport’s deep knowledge of the provider enrollment process and established relationships with payer groups proved to be a huge asset for the project.
The consolidation required Newport to work with Penn Medicine’s large number of payers (including Medicare, Independent Blue Cross and all other Blues Plans, Aetna and many others). Newport was involved in the process to create new national provider identification numbers (NPIs) and make sure the group NPI’s and Physicians were correctly associated with our designated tax ID number.
The project was a massive undertaking that required diligent follow-up. If NPIs were not set up correctly in the payers’ systems, the claims would go unrecognized, and potentially not paid. The team at Newport has proven they have the knowledge, the resources, and the follow-through to meet the demands of this cumbersome task. Without leveraging the services of Newport, to undertake a project of this size internally Penn Medicine would have had to hire additional staff. Even with the added resources, without the knowledge and experience that Newport’s staff brought to the table, it would have taken the Penn Medicine team significantly longer. To learn more about how our custom credentialing services can benefit you, please contact us.