Credentialing Services for Federally Qualified Health Centers (FQHCs)

Newport understands that FQHCs serve a vital role in our country’s healthcare delivery network by providing a safety net for medically underserved populations.

With the implementation of the Affordable Care Act and Medicaid expansion, Federally Qualified Health Centers serve the healthcare needs for more than 22 million people in more than 1,200 centers nationwide – without any regard to the patient’s ability to pay. That’s why it’s critical to ensure that all eligible payments for services performed in these centers are received – and if providers in these community clinics are not enrolled properly, the centers will not be paid properly.

As not-for-profit entities, Federally Qualified Health Centers will often lack many of the internal resources required to implement and maintain quality provider enrollment procedures to ensure proper and consistent reimbursement. Couple that with the fact that many of these centers face high rates of provider-staff turnover, it’s no wonder that many federally Qualified Health Centers leaders who strive to improve revenue, reduce costs, and improve community access – without sacrificing quality of care – are turning to experienced partners like Newport for help.

By partnering with Newport, Federally Qualified Health Centers are able to improve their center’s financial performance and improve operational efficiency by relying on Newport’s thoughtful blend of cloud-based technology and services. Newport focuses on managing the entire credentialing life cycle through the use of cloud-based workflow software, advanced cloud-based reporting, and analytics coupled with industry defining domain expertise. Working with Federally Qualified Health Centers of all sizes, Newport seamlessly blends into our client’s culture to offer best in breed credentialing software and services. This unique approach gives centers real-time analytics and access to powerful workflow tools to manage their credentialing lifecycle.

Newport’s Value

Interactive approaches to corporate strategy foster collaborative thinking to further the overall value proposition.

Improve Revenue 100%
Bundled Software and Services 100%
Client Satisfaction 100%
Reduced Costs 100%

Newport’s Value

Interactive approaches to corporate strategy foster collaborative thinking to further the overall value proposition.

Improve Revenue 100%
Bundled Software and Services 100%
Client Satisfaction 100%
Reduced Costs 100%

Initial Credentialing Services

  • On-site or remote demographic and primary source documentation collection
  • Rapid data entry into our Cloud-Based workflow, analytics, and business intelligence software; CARE
  • Comprehensive Par/Non – Par Analysis
  • Missing demographic and documentation review
  • Application and signature page consolidation and management
  • Quality Assurance
  • Use of UPS, FedEx, and/or Certified Mail to track send and receipt of applications
  • Dedicated Application Follow-up
  • Extensive Payer Contacts
  • Compilation of all Provider Identification Numbers (PINs)

Expirables Management Services

  • Pro-Actively Monitor Document Expiration (e.g., license, DEA registration, board certification)
  • Conduct all CAQH Re-Attestations (every 120 days)
  • Expiring Document Report
  • Respond to Provider Enrollment Billing Issues/Edits

Re-Credentialing Services

  • Conduct all re-credentialing services based on insurance plan requirements
  • Quality Assurance
  • Application and Signature Page Consolidation and Management
  • Use of UPS, FedEx, and/or Certified Mail to track send and receipt of applications
  • Dedicated Application Follow-up

Credentialing Edit and/or Denials Management Services

  • Manage all credentialing related edits (stratified by dollar)
  • Manage all credentialing related denials (stratified by dollar)

Dedicated Account Management

  • Dedicated credentialing specialist to manage all aspects of your credentialing life cycle
  • Weekly dedicated meetings to review progress and performance
  • Weekly reporting to track performance

Advanced Reporting

  • Cloud-based, real time access to advanced institution wide dashboards
  • Ability to view financial impact of delayed credentialing by linking gross charges to “in-process” credentialing applications
  • Ability to develop your own KPI reports through easy to use, click, drag, drop reporting
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