DATAIPO  LLC

Credentialing Services

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• CAQH (Council for Affordable Quality Healthcare)

• Tax ID/ EIN (IRS.gov)

• NPI (National Plan and Provider Enumeration System (NPPES))

• Set Up your Private Practice ( *LLC - Call, LegalZoom) If DATAIPO LLC handles for you = Flat Fee(suggested) = $60.00 + LegalZoom's Fee(s)

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• Turnaround time = status communication within 2-3 business days (depending status on CAQH, availability of your documents, turn-around of the Insurance Panel(s)).

  • Note: Industry Standard for a complete Credentialing cycle = 6 - 8 weeks, at times 6 months or more 

    • The reason for the lengthy process is the requirement for submission of extensive background information. Depending on the circumstances, the clinic or organization for which the provider is working may also need to go through credentialing. In the past, each provider had to be individually credentialed with each individual health insurance plan. For some, this is still the case. Many health insurance companies, however, are now using a centralized database, CAQH

    • Reminder: Providers can only get credentialed on panels they are qualified for.

 

• Default Application(s) = CAQH, most Major Insurances (Uploads / Imports), Google: Drive, Folders, e-mail, Calendar, Docs, Sheets, Microsoft Office: Excel, Word, Project

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• Agreement on Statement of Work = After we agree on: the stakeholders, timeline, application(s)/access used and the fee, payment method  by signing and dating the information will be processed and completed within the agreed turnaround time.

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• Payment Method =  Square, Zelle, Credit Card      

  • Frequency =  Weekly (or as per contract)

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• PRICING (Suggestions, negotiable):

  • Retention Fee ('RF' for Service 1,2,3) = $50.00

       

•  Service 1: Initial Set Up, NO CAQH ID & NO Profile content & Get Pertienet Documentation for e-filing = Flat Rate = RF + $90.00 = $140.00

  • Includes: Getting your CAQH ID & Password, all the pertinent Provider profile information (Your: Name on your License, Date of Birth, e-mail, Phone Number, Licence number, Tax Id, NPI, etc...) as well as add you to 1-Initial Insurance Panel that are accepting providers in your area and that you qualify to join.
  • Set up Electronic Funds Transfer

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• Service 2: Verification and maintenance of existing CAQH ID, Profile content  & some Documentation already e-filed = Flat Rate = RF + $80.00 = $130.00

  • Includes: Accessing your CAQH ID & Password, work with the pertinent Provider profile information and/or get the rest of the updated information, any updated documentation as well as add you to 1-Initial Insurance Panel that are accepting providers in your area and that you qualify to join.

  • Set up Electronic Funds Transfer

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• Service 3: Paneling Only   (Add/Maintain: Payers / Insurance Panels) = Per Provider, Per 1 Insurance Panel = $80.00

  • Includes: Per Insurance Panel Adding/ Maintaining  (after Initial Set Up with a CAQH id was completed).

  • Work with Insurances: that are accepting providers in your area and that you qualify to join. Where applicable link updates to CAQH.

  • Set up Electronic Funds Transfer

    • Multiple Insurance Panels Additions:

      • Bundle of 2 panels = RF + $100 = $150.00 (see RF payment above)

      • Bundle of 3 panels = RF + $150 = $200.00 (see RF payment above)

      • Bundle of 4 panels = RF + $200 = $250.00 (see RF payment above)

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• Service 4: Re-Attestation(s): Documentation & CAQH Maintenance = Per Attestation Cycle =  $20.00  (Weekly reminder requesting update data = $5.00)

  • Includes: Updating with provider data: business information, service address, licenses, liability insurance etc... as required.

 

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Process Summary - HIPAA Compliant:

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​INPUT =  Simple and Secure.  

• Get Temporary and Secure Access to your CAQH profile

• Confirm Business, Group and/or Provider's information: Provider: Name,Date of Birth, e-mail, ID and Tax information, Panel information, etc...

• Send Current Documents by e-mail Attachments (signed and dated) / Scanned / FTP for processing.

• Gather the data and file the current and correct version of the document(s) needed.

 

PROCESSING = Quick and Efficient. 

• Professionally, clearly and timely communicate with you and insurance company representatives to gather and file information.

• Provide status on Credentialing efforts.

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OUTPUT=  Accurate and Timely.

• Complete the set up on all the insurance panels that you are qualified to start billing!

• File handling: all files are secured in CAQH and on a secure system once the credentialing cycle is completed (or filed in the agreed manner).

• Disable any Temporary ID(s)  [AFTER PROJECT COMPLETION].