Are you being buried in a mountain of paperwork?
Do you look forward to spending 10-20 hours of your time and waiting 30-120 days before you
finalize your desired insurance participation? We doubt it.
Our clients let us manage their credentialing needs.
Most people don’t enjoy doing paperwork - which is why we complete
over 3,500 applications each year. So, whether you want to join or leave plans, update directory
information or remove your listings from previous employers, Five Lakes can manage all of it.
We’re very good at it - and we actually like it.
We make it easy. And fast.
Simply choose from a list of PPO plans or let our PPO Insurance Analysis drive your insurance
participation decisions. Five Lakes provides full-service credentialing for PPO plans across the
country. You’ll have plenty of choices and life will be easier.
We’ll help determine the very best plans based on YOUR practice and YOUR goals.
We’ll complete your applications with accuracy and attention to every detail.
We submit your applications, track the status and handle any issues during the process.
Credentialing is the process that reviews a provider’s
qualifications and credentials including their education,
training, residency, licenses, specialty certificates, work and malpractice history.
Credentialing must be completed in order to participate with insurance carriers for most network types. Providers are credentialed upon first time enrollment for participation and then regularly afterwards, around every 3 years, depending on the state. Credentialing must abide by the standards set forth by regulatory and accreditation organizations such as the National Committee for Quality Assurance (NCQA).
Once a provider enrolls with an insurance carrier for the very first time, that initial credentialing is valid for approximately 2-3 years, depending on the carrier and the state in which you practice.
Providers become due for re-credentialing once this 2-3 year time period has lapsed and they are required to resubmit documents to become “re-credentialed”. This is the process in which the insurance carriers re-verify licenses, malpractice history and other provider information.
Let us help you get better insights into your marketplace so you can make more informed decisions.
Call us at 877.955.2537 or click the button below.
We are happy to provide you with a free consultation and talk about your business goals.