We work with many clients in Texas and would be happy to assist you with any practice management, credentialing, or practice start-up needs. We provide a variety of services to fit your needs and custom design each proposal to make sure you only pay for what you need.
Here is a basic list of services provided to our Texas clients:
1. Work to ensure that the client is properly credentialed with all necessary commercial, workers compensation, and government payers (as many as needed) based on Client’s practice location. Company will ensure that the NPI number for the individual and group are set up correctly so that the Medicare crosswalk can perform correctly.
2. Company will establish the newly formed group with all applicable payers including Medicare & Medicaid.
3. Company will deliver to Client the necessary ERA/EFT applications to assist in setting up electronic billing.
4. Company will negotiate commercial and workers compensation contracts in order to achieve the highest possible reimbursements for Client’s services. Company will weight every contract according to the most frequent CPT codes and current local Medicare rates.
5. Company will assist in obtaining and setting up client’s Group NPI number and individual CAQH provider number.
6. Company can and will assist to the best of our ability with the completion of all applications and requests for information. Client is responsible for signing all applications and verifying the information as completed by Company.
7. Company will assign a account manager and will track the progress of all applications, fee schedules, and contracts to ensure a fast and efficient enrollment process.
8. Company will provide weekly or bi-weekly updates on the status of all activities and be available for any questions or concerns.
9. Company will at all times strive to perform our duties to the satisfaction of our client and will maintain the highest standards of character and business ethics.
10. For hospital credentialing, we will charge two hundred and fifty dollars ($250) per physician per hospital. Hospital credentialing fees are billed upon the successful completion of the necessary hospital applications.
11. Company will set up LLC, PA, or Corporation and obtain Client’s EIN for an additional fee of $300.00. Client is responsible for any fees associated with forming a new business in the state of Texas.
12. Company can obtained a certificate of exemption (Clia Waiver) for client for a fee of $250.00.
13. Company will maintain the credentialing status of practice for the first six months at no additional cost.
14. Company can provide billing and management services for an additional monthly fee. Common services include a monthly productivity analysis, AR reporting and management, claim denial oversight, compliance management of staff, contract negotiations for vendors, recruitment services for physicians or mid level practitioners, employee handbook, and financial services using our CPA. *Price can vary up or down depending on the group size and services needed.
15. Company can also provide payroll management, accounting and business development services for additional fees.
Here are some of the insurers that we work with in the Texas market. There are many insurance companies that might be worth participating with depending on your location. We also work with numerous workers compensation networks that may be beneficial to your practice.
- Medicare
- Medicaid
- Humana
- BC/BS of Texas
- UHC
- Cigna
- Aetna
- Tricare
- Select Care/Texan Plus
- Kelsey Seybold
- Tricare Humana
- Tricare United
- HealthSpring
- BeechStreet-MultiPlan-PHCS
- Coventry/Advantra/First Health
- Fortified Provider Network
- Galaxy Health Network
- Great West
- Texas True Choice
- InterPlan
- National Provider Network
- Plan Care America
- Prime Health Services
- Three Rivers Provider Network
- United Mine Workers
- USA Managed Care Organization
- USFHP
- Wellcare of Texas
- Care Improvement Plus
- Sterling Health Plans
- Universal Health Plans
Top Texas Cities that we provide services to: