Amerigroup Credentialing Services

We are a forward-thinking medical billing company with high ambitions. We sought to make it possible for group practices, hospitals, clinics, and independent medical practice practices to run a healthcare business without feeling obligated to meet a set profit target. We go above and above to provide revenue cycle management services that help medical practices meet their financial and regulatory obligations. Our services have been designed to fit with value-based care reimbursement models. Our RCM professionals can help you choose and implement MACRA regulations. And our RCM automation technologies provide you control over data.

You Make the Lives Better for Your Patient. We’ll Empower You

Our prior authorization, referrals, claims, and payment processes are streamlined to help you focus on what you do best — caring for your patients

We are here to help you with

  • A patient-centered approach to care that includes creative patient outreach and education
  • Resources for disease and case management
  • Transformation of the medical home to be more patient-centered.
  • Self-service tools and live-agent support are available online
  • Staff from Provider Relations in your area is dedicated to your success

We are specialized

Transition to value based care

We assist your healthcare business in making the difficult shift to value-based reimbursement.

Patient financials

With the help of our patient billing experts, you can adapt to the era of healthcare consumerism. Increase the amount of money collected from patients’ net pay.

Specialty focused

To tackle your coding needs, we have specialist teams of medical coders with specialized specific certificates.

Get Better Performing Contracts

There is a clear power imbalance between insurers and healthcare providers. The advantage is with the payers. Our expert contract negotiators will tip the scales in your favor. Because well-managed contracts will protect your revenue stream while also providing long-term financial benefits. RVU values are something we do. By evaluating EOBs, our contract negotiation team examines payments for specific services. Internal claims data is mined, and denied/rejected claims are extensively examined. It’s a good idea to talk about payment difficulties directly at the negotiating table. This, more often than not, reduces denials and guarantees that our clients have stronger contract clauses this time around.

For successful contract talks, you must first understand the payer’s profile. After more than a decade of contract negotiations, we’ve figured out what works. Negotiating a contract is about more than just getting better prices. It’s a chance to talk about new insurance products and plans, risk-sharing models, payment regulations that are changing, and payer-employer connections. That is why you need someone like us to handle your negotiations, as we have a lengthy working connection with them.

What Are Your Biggest Stumbling Blocks?

  • Knotty reconciliation processes
  • Surface knowledge of Federal billing regulations
  • Credentialing tripwires
  • Change in existing plan and addition of plans every year

Get Amerigroup Credential with Us

Do you despise the process of obtaining credentials? Insurance company credentialing is nerve-wracking, time-consuming, and cyclical. Our Certified Provider Credentialing Management Professionals will help you get accredited quickly. Our licensed professionals serve healthcare organization of all sizes and types, including group practices, accountable care organization (ACOs), hospitals, preferred provider organization (PPOs), surgical centers, healthcare networks, and independent physician practices.

All of your original credentialing, re-credentialing, dynamic credentialing, and contracting needs are handled by our qualified credentialing specialists. Within 45 days, we do primary source verification of items.

Our Credentialing Experts Help You

  • Take care of the all credentialing tasks
  • Provide assistance with Medicare revalidation
  • In-network/contract physicians
  • Obtain the allowable stipulated in the contract
  • Assist with NPI registration
  • Deal with difficulties relating to managed care contracts

What Should You Send Us?

If you’re adding a new provider to an existing group, please fill out the form below.

  • Each provider’s information:
  • Full name(s) (first, middle, and last names, both formal and informal, former, as well as suffix)
  • NPI (National Product Identification Number)
  • Identifier (ID) number for Medicaid in Washington
  • The Council for Affordably High-Quality Healthcare is a non-profit organisation dedicated to (CAQH)
  • If applicable, the provider’s phone number
  • Submission of attachments is required.
  • Name of the practice in its entirety, as well as its tax identification number (TIN)
  • The address of the site

The practice will begin on the effective date of the provider.

We Keep You Updating About

  • Credentialing Management
  • Credentialing Status
  • Credentialing follow-up Reminder
  • Paperwork Management
  • Federal Revalidation Reminder & Alert
  • Automatic Weekly Reporting Alert
  • Query Tracking, Messaging & Ticketing application

Benefits of Working with Us

  • A comprehensive set of RCM analytics and KPI tracking tools helps you improve your financial performance.
  • Guaranteed a first-pass claim acceptance rate of 98 percent and medical coding accuracy of 97 percent.
  • Reduce AR backlogs and improve your revenue cycle with a 24/7 workflow.
  • We provide you with the tools you need to scale up and streamline your operations in order to accommodate value-based reimbursement models.
  • Downtime, delays, and lost production are minimized thanks to technical and professional capabilities.
  • Security regulations set by the industry were followed. Data security methods and encryption protocols that are cutting-edge.