Credentialing and Contracting

Optimize your practice operations with seamless credentialing and contracting support that ensures compliance and efficiency.

Provider Enrollment and Credentialing

Simplify provider onboarding with end-to-end credentialing support for insurance payers and network inclusion.

Contract Negotiation and Management

Leverage expertise in contract review, negotiation, and compliance to secure favorable terms for your practice

Compliance and Documentation Support

Stay compliant with payer requirements and regulatory standards through accurate and timely documentation

A Person Writing on a Paper with Graph<br />

By the Numbers

50+ Insurance Networks

Supported for credentialing and contracting annually.

30 Days

Average time saved on provider enrollment processes.

 

100% Accuracy

Maintaining compliance with payers and credentialing guidelines.

Credentialing and Contracting Service

Credentialing and contracting are two of the most critical elements for any healthcare provider looking to expand their patient base and improve financial health. Without being properly credentialed with insurance networks, a provider can miss out on vital patient care and reimbursement opportunities. Similarly, practices may struggle with insufficient reimbursements without strategically negotiated payer contracts, potentially hindering their growth. Kona Medical Consulting combines credentialing and contracting to ensure your practice has the best chance to succeed in an increasingly competitive healthcare marketplace.

Contracting with insurers and payers is the next crucial step to ensure your practice is financially stable and well-positioned to grow. At Kona Medical Consulting, we work on your behalf to negotiate favorable contracts with insurance companies. Our team has extensive experience in understanding the intricacies of insurance reimbursement policies, and we advocate for the best possible rates and terms for your practice. We ensure that your payer contracts are optimized for your financial goals and that any discrepancies or unfavorable clauses are addressed and rectified. By negotiating strategic agreements, we help you secure the highest possible reimbursement for your services, allowing your practice to thrive.

Managing credentialing and contracting can be complex and time-consuming, especially with ever-changing payer requirements and compliance standards. Our team specializes in simplifying these processes for healthcare practices, ensuring timely provider enrollment, accurate documentation, and seamless communication with insurance payers. We take the burden off your team, allowing you to focus on delivering excellent patient care while we handle the administrative complexities. From negotiating favorable contract terms to ongoing compliance, our experts ensure your practice runs efficiently and profitably.

Simplified Credentialing and Contracting for Every Specialty

Provider Credentialing

Payer Contract Negotiation

Contract Renewals & Amendments

Credentialing Verification

Medicare/Medicaid Enrollment

Insurance Network Enrollment

Provider Enrollment Support

CAQH ProView Management

Reimbursement Rate Negotiation

Contract Compliance Monitoring

Credentialing Expiration Tracking

Audit & Review Documentation

Credentialing Audits

Risk Management for Contracting

Payer Relations Management

State & Federal Compliance Support

Telemedicine Credentialing & Contracting

Insurance Credentialing for Multiple Payers

Out-of-Network Contract Negotiation

Credentialing for Specialized Healthcare Providers

What We Offer

Compliance Support

  • Adhering to state, federal, and payer-specific guidelines.
  • Assistance with audits and ensuring compliance to minimize risks.

Provider Credentialing

  • Initial credentialing for new providers.
  • Re-credentialing and maintaining compliance with payers.
  • Assistance with CAQH ProView and Medicare/Medicaid enrollment.

Payer Contracting

  • Negotiating contracts with insurance networks and payers.
  • Securing competitive reimbursement rates.
  • Handling amendments and renewals of existing contracts.

Maintenance and Monitoring

  • Ongoing monitoring of credentialing expirations.
  • Regular updates to payer rosters to ensure active status.
  • Full-service reporting and documentation for audits or reviews.

Pricing

Ready to streamline your operations and elevate your practice?

Per Provider: Starting at $500 per provider for initial credentialing

Ongoing Maintenance: Retainer packages starting at $1,000 per month, which include re-credentialing, contract updates, and monitoring

 

Need Related Services?

Claims Management

Simplify and accelerate your claims process with our comprehensive management services. We ensure accurate submissions, reduce denials, and improve reimbursement turnaround times while providing actionable financial insights.

 

Provider Enrollment

Streamline the enrollment process with payers and insurance networks. From credentialing assistance to maintaining compliance with regulations, we ensure your providers are enrolled swiftly and efficiently, saving time and resources.

 

Contract Negotiations

Maximize your financial outcomes through strategic payer contract negotiations. Our experts secure competitive reimbursement rates, handle contract amendments, and manage renewals to keep your practice running smoothly.

 

Skip to content