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CVO and Enrollment Services
Credentialing Products
• Comprehensive Plan Enrollment
o Assisting practices since 2003
o Expertise & industry experience
o Proven results for over 3,000 providers
o Multi-state experience
o More cost effective than hiring credentialing staff
• Hospital Application Production and Submission
o New product to coordinate hospital privileging
o Share your credentials once for plan and hospital credentialing
• NCQA Certified Credentials Verification Organization(CVO)
o Delegated credentialing with minimal costs
o Credentialing for facilities, plans and hospitals
Comprehensive Enrollment Services
Reduce credentialing denials and keep up with new plans, re-
credentialing and expirables...
•Group and individual applications for all plans
•Medicare & Medicaid included
•Specialty Networks (behavioral health, radiology, etc.)
•Re-validations (Medicare & Medicaid hot topic for 2012
through 2015)
•CAQH always included
And...Hospital Medical Staff application service available
NCQA Certified CVO
Is your large group, facility or IPA responsible for credentialing your
providers?
●A CVO performs a quality review of providers for large physician
groups, facilities and health plans/networks with credentialing
responsibilities.
●Delegation for large groups can eliminate months of waiting for
plan credentialing. Ask us how.
●MDeverywhere CVI is among only 23 NCQA Certified CVOs
serving external clients
Expertise and Service
Personal and Professional service - Credentialing
Coordinator and Manager for each account
Loyal and satisfied clients since 2004
National Presence
Certified Professional Credentialing Specialist
(CPCS) on staff
Over 35 years’ senior-level health plan
experience
MDe RCM & Credentialing - Perfect Together
Credentialing and CVO services available independently
or in conjunction with our RCM solution
•Credentialing issues impacting claims are logged and tracked
until resolution
•Claims projects and re-submissions are handled without
delay
•New enrollment information communicated to operations
immediately
•New providers are credentialed in a timely manner - our
incentives are aligned - “No $$ left on the table”
•Unique RCM Solution with expertise in credentialing
The MDeverywhere Advantage
Reputation & Quality
Experience
Value
Enrollment Client Testimonial
“We have utilized your credentialing services for the past seven years for
our hospital-based group and have seen a marked improvement in our
receivables. Your credentialing staff is always
professional, polite, knowledgeable and most importantly available and
responsive to all our needs.”
Director, Patient Accounts for a large NY Metropolitan Hospital (500 providers credentialed -
enrollment client since 2004)
Contact Us
Jackie Mayer, MHA
VP, Manager Care & Credentialing
Phone: 631-232-4260 Ext. 758
Email: jackie.mayer@mdeverywhere.com
THANK YOU

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Credentialing Services by MDeverywhere

  • 2. Credentialing Products • Comprehensive Plan Enrollment o Assisting practices since 2003 o Expertise & industry experience o Proven results for over 3,000 providers o Multi-state experience o More cost effective than hiring credentialing staff • Hospital Application Production and Submission o New product to coordinate hospital privileging o Share your credentials once for plan and hospital credentialing • NCQA Certified Credentials Verification Organization(CVO) o Delegated credentialing with minimal costs o Credentialing for facilities, plans and hospitals
  • 3. Comprehensive Enrollment Services Reduce credentialing denials and keep up with new plans, re- credentialing and expirables... •Group and individual applications for all plans •Medicare & Medicaid included •Specialty Networks (behavioral health, radiology, etc.) •Re-validations (Medicare & Medicaid hot topic for 2012 through 2015) •CAQH always included And...Hospital Medical Staff application service available
  • 4. NCQA Certified CVO Is your large group, facility or IPA responsible for credentialing your providers? ●A CVO performs a quality review of providers for large physician groups, facilities and health plans/networks with credentialing responsibilities. ●Delegation for large groups can eliminate months of waiting for plan credentialing. Ask us how. ●MDeverywhere CVI is among only 23 NCQA Certified CVOs serving external clients
  • 5. Expertise and Service Personal and Professional service - Credentialing Coordinator and Manager for each account Loyal and satisfied clients since 2004 National Presence Certified Professional Credentialing Specialist (CPCS) on staff Over 35 years’ senior-level health plan experience
  • 6. MDe RCM & Credentialing - Perfect Together Credentialing and CVO services available independently or in conjunction with our RCM solution •Credentialing issues impacting claims are logged and tracked until resolution •Claims projects and re-submissions are handled without delay •New enrollment information communicated to operations immediately •New providers are credentialed in a timely manner - our incentives are aligned - “No $$ left on the table” •Unique RCM Solution with expertise in credentialing
  • 7. The MDeverywhere Advantage Reputation & Quality Experience Value
  • 8. Enrollment Client Testimonial “We have utilized your credentialing services for the past seven years for our hospital-based group and have seen a marked improvement in our receivables. Your credentialing staff is always professional, polite, knowledgeable and most importantly available and responsive to all our needs.” Director, Patient Accounts for a large NY Metropolitan Hospital (500 providers credentialed - enrollment client since 2004)
  • 9. Contact Us Jackie Mayer, MHA VP, Manager Care & Credentialing Phone: 631-232-4260 Ext. 758 Email: jackie.mayer@mdeverywhere.com THANK YOU