Credentialing and Contracting

Our Credentialing and Contracting Services

At Spectrum Healthcare Management, our experienced teams provide comprehensive contracting and credentialing services to healthcare providers. Our contracting solutions involve negotiating optimal agreements with insurance to establish fair reimbursement rates and network participation terms. We leverage our industry knowledge to secure favorable contracts that strengthen your practice financially.

Our skilled and professional team also handles the end-to-end credentialing process, conducting primary data collection and submitting the required documentation across payer systems. We guide and consult providers to meet all licensing, education, certification, and other requirements to swiftly register with insurance networks. With ongoing updates, we keep service provider credentials current across all plans. Our combined contracting and credentialing services enable smooth operations, allowing clinicians to focus on delivering care.

  • Contract Negotiation And Execution

    With our insights into payer contract trends, we negotiate favorable terms and reimbursement rates while handling contract finalization, execution, and ongoing management.

  • Provider Enrollment and Network Registration

    We efficiently guide providers through payers’ enrollment and registration processes to get client providers fully contracted on networks in a timely manner.

  • Ongoing Payer Relationship Management

    By maintaining strong payer relationships, we ensure your practice remains compliant and takes advantage of opportunities for improved contract terms through renegotiation.

  • Source Verification and Requirements Tracking

    We verify all required licenses, certifications, and other credentials through sources and ensure all eligibility elements are continually met per payer’s terms.

  • Credentialing Process Management and Updates

    Our experts oversee the entire credentialing lifecycle, keeping provider credentials updated across all plans through diligent tracking and seamless renewals.