Outsource Medical Credentialing and Contracting with Healthcare Revenue Group

Credentialing Made Seamless with HRG 

Credentialing is the cornerstone of participating in insurance networks and providing quality patient care. HRG handles every aspect of credentialing with precision, ensuring your practice meets payer and regulatory standards. 

How HRG Simplifies Credentialing: 

• Collecting and Submitting Applications: We gather and prepare all necessary documentation, from education history to certifications. 

• Primary Source Verification (PSV): HRG manages verification with licensing boards, medical schools, and other sources, saving you countless hours. 

• Background Checks and Clinical Privileges: Our team oversees background checks and coordinates with hospitals to secure your clinical privileges. 

With HRG, credentialing isn’t just a task—it’s a seamless, strategic process tailored to your practice’s needs. 

Contracting with Confidence: HRG’s Expertise 

Contracting defines the terms of your participation in insurance networks, from reimbursement rates to compliance requirements. HRG brings unmatched expertise to every stage of contracting, ensuring favorable terms for your practice. 

How HRG Optimizes Contracting: 

• Reimbursement Rate Negotiations: Our experts secure competitive rates to enhance your financial stability. 

• Comprehensive Contract Review: We analyze terms for clarity, ensuring compliance and protecting your interests. 

• Network Selection and Participation: HRG helps identify the most beneficial insurance plans based on patient demographics and revenue goals. 

• Regulatory Compliance: Our team ensures adherence to regulations like HIPAA and Stark Law, safeguarding your practice from risk. 

With HRG, contracting isn’t a negotiation—it’s an opportunity to strengthen your practice’s financial foundation. 

Integrated Credentialing and Contracting Services 

Credentialing and contracting work hand-in-hand to support your practice’s growth and medical billing success. When you outsource credentialing and contracting with HRG, you can relax as our holistic approach ensures that every detail is aligned with your goals.  

What HRG Handles for You 

• Medicare and Medicaid Enrollment: We expertly manage the enrollment process for these essential government programs. 

• Initial Payer Contracts: HRG secures agreements with new payers to expand your practice’s network. 

• Updating Payer Contracts: We ensure your contracts stay current with evolving regulations and practice needs. 

• Rate Negotiations: Our team negotiates competitive reimbursement rates to boost your financial stability. 

• Rate Renegotiations: We advocate for rate adjustments based on new hospital privileges, specialties, or market conditions. 

• Provider Services: 

• • Licenses: Assistance with acquiring and maintaining provider licenses. 

• • Hospital Privileges: Coordination with hospitals to establish clinical privileges. 

• • CAQH Profile Management: Creating and maintaining your CAQH profiles for easy payer access. 

• • Credentialing with Payers: Managing the entire credentialing process with insurance providers. 

• • Contract Negotiations: Securing favorable terms for your practice. 

• • Specialty Privileges: Credentialing for specific specialties to expand your practice offerings. 

• Credentialing Across Specialties: Expertise in telehealth, home health, durable medical equipment (DME), and more. 

• Emergency Contract Management: Rapid response to contract terminations or payer disputes. 

• Holistic Credentialing Support: We handle everything from application submissions to clinical privileges. 

• Payer Mergers and Acquisitions Tracking: Monitoring payer changes and their impact on your practice. 

• Legal Collaboration: Working directly with your legal counsel to ensure clear, compliant contracts. 

• Firefighting Services: Immediate action to resolve urgent issues like terminated contracts. 

HRG’s comprehensive services cover every detail, ensuring your practice is credentialed, contracted, and ready to succeed. 

HRG: The Partner Your Practice Deserves 

Flexible, Transparent Solutions: 

• No minimum contracts or terms—pay only for the hours spent. 

• Monthly budget control with real-time updates and pre-invoice sharing. 

Unmatched Accountability: 

• Work is done directly in your systems, so you’re always in the loop. 

• Frequent meetings ensure alignment with your leadership team. 

Proactive Communication: 

• You’ll have direct access to the experts managing your credentialing and contracting. 

• Our team persistently follows up so that nothing falls through the cracks leading to headaches when it comes to reimbursements.  

Tailored Service: 

• Big enough to offer robust workflows, small enough to know every client personally. 

• Expertise across various healthcare sectors, from hearing centers to specialty providers like podiatrists to university faculty and everyone in between.