Provider Enrollment & Contracting

At Vitgenix, Inc. we strive to protect providers with administrative processes of enrollment and enable them to concentrate on securing precious human lives.

VITGENIX, INC.

Request Enrollment Services

Credentialing Factors

Vitgenix, Inc. provides comprehensive credentialing services to streamline the provider enrollment and contracting process, avoiding claim delays, saving time and costs.

Vitgenix, Inc. regularly observes following factors while providing enrollment and credentialing services

VITGENIX, INC.

Provider Enrollment Services

Application Preparation

We prepare and submit the necessary applications to the payers once we gather all of the necessary documents.

Contract Enactment

Once the initial step of physician credentialing is finished, we guarantee that insurance companies propose and sign contracts to complete the enrollment process.

CAQH Enrollment

To register providers as individuals, CAQH (Council for Affordable Quality Healthcare) applications are submitted to payers.

Payers Follow-up

Strong communication is maintained with payers for verifications, follow-ups on in-process applications, and tasks related to provider enrollment and contracting.

Data Collection and Verification

Assisting providers and front office staff in gathering the necessary demographic and backend information. Data validation for rectification and document validity to guarantee proper information is delivered to insurance companies on first attempt.

Application for Hospital Privileges

Assist in obtaining hospital privileges, which are necessary by most insurance companies in order to process the provider enrollment application and issue a contract. We handle everything from application submission through application follow-up and completion.

ERA & EFT Setups
Reassignments
Renewal of Contracts
Out of Network Fee Schedules
EDI Setups with multiple EMRs
In-Network and Out of Network contracts

Provider Enrollment Benefits

Get paid faster
Remove the stress caused by bunches of paperwork, countless applications, and insurance follow-ups.
Save hundreds of hours doing manual work
Free up your staff to concentrate on useful work
Increase no of referrals and patients
Finest Customer Service with a dedicated team lead
Services included info collection, submission, follow-ups, faxes & Emails
24x7 access to all your papers and the progress of your applications

Frequently asked questions

How much time does it take?

A new provider or group usually takes approximately 120 days to be fully credentialed. Some payers take 30-60 days while others may take up to 150 days to

What are the advantages of CAQH, and how does one apply?

An overview of CAQH includes the following benefits:

CAQH (Council for Affordable and quality healthcare) is known for its unified database including industry-wide standards and fully supports expediting the credentialing process.
Around 90% of payers use CAQH as a compulsory part of provider enrollment.
Instead of calling the provider, a copy of any document related to provider history can be taken directly from the CAQH file.

Credentialing process of CAQH:

Obtaining CAQH ID 2-3 business days
Username and password set up
Online application Form and submission of the required documentation
Signature attestation to verify the application
Allow insurance companies to access your application
You may now begin the credentialing/contracting process with the insurers

When will Credentialing services become available?

After receiving the proposal and credentialing documents, Your enrollment process will be started within 3 business days.

What documentation is needed for credentialing?

Document Required for Individual Provider:

State License
Certificate of Malpractice Insurance (COI)
Federal DEA License
State DEA License (CDS License; if required by state)
Board Certification(s)
Current CV (use MM/YYYY format; show current employer)
Driver’s License
Diploma (highest level of education)
ECFMG Certificate (for providers educated outside the United States; Educational Commission for Foreign Medical Graduates)
Collaborative Agreement (required for Nurse Practitioners only)
Prescribing Arrangement Letter (for providers not holding federal DEA License)
Admitting Arrangement Letter (for providers who do not have active hospital admitting privileges)

Legal entity documents (copies only for license and certificate requirements):

State Business License
Certificate of Malpractice Insurance (COI)
CLIA Certificate (if applicable; Clinical Laboratory Improvement Amendments of 1988)
IRS W-9 Form
IRS Form CP575 or replacement letter 147C (verification of EIN/TIN)
Bank Account Verification Letter or a copy of the voided check

Note: This is a common list of the documentation often requested by insurance companies for regular providers, groups, or facilities. Third-party insurance may require more or different documentation to complete the healthcare credentialing process, depending on the type of provider and services provided