Fast, accurate and NCQA-compliant Credentialing
Synova's credentialing service leverages advanced, NCQA-compliant tools to simplify data collection, analysis, and submission to payers. This ensures a seamless application process and maximizes your acceptance rate.
helps with
- Gathering and collating data
- Analyzing and submitting data to payers
- Enhancing healthcare and patient care quality
Automated Data collection and Population in CAQH
We go beyond basic CAQH profile maintenance. We create profiles for new providers and utilize our cutting-edge technology to automate the 120-day re-attestation process, guaranteeing providers' profiles and insurance documents stay continuously updated and compliant.
helps with
- Automatic renewal every 120 days
- Up-to-date provider profiles
- Consistent insurance documentation
Mutually-favorable Contracting
Our meticulous fee schedule analysis goes beyond basic review. We identify opportunities to maximize your reimbursement rates through negotiating favorable contract terms.
helps with
- Optimizing reimbursement rates
- Enhancing financial outcomes
- Identifying improvement opportunities
License Tracking and Expiration Management
Synova tracks provider licenses, monitors expiration dates, and sends automated notifications for renewal, ensuring ongoing compliance and reducing the risk of working with providers with expired licenses.
helps with
- Maintaining compliance
- Reducing administrative burden
- Preventing lapses in provider licensure
Increased Administrative Burden
An overwhelming amount of forms, applications, and documentation, coupled with the inability to efficiently credential across multiple states or locations, takes staff away from revenue-generating activities.
Underutilized Revenue Potential
Credentialing delays or errors can impede billing and reimbursement, while network exclusions and suboptimal contract terms negotiated without expertise lead to significant financial losses.
Lack of Expertise to Effectively Evaluate Payer Contracts
Providers struggle to optimize terms like fee schedules and reimbursement methodologies and face difficulty pushing back on unfavorable payer contract language.
Problems with Maintaining Compliance
Keeping up with frequently changing payer rules, regulations, and credentialing requirements is challenging, often resulting in missed re-credentialing deadlines that can lead to terminations.
Measurable Impact
Fast Track Licencing
We leverage expertise in PECOS for rapid Medicaid and Medicare credentialing across Florida, Texas, California, and other key states. Our team navigates regional regulations for a seamless process.
Maximize Reimbursement Opportunities
Achieve industry-leading first-pass application rates and optimize provider reimbursement arrangements for maximized payouts.
Generate Type I and II NPI
We generate Type I NPIs for fresh graduates and Type II NPIs for newly formed groups. NPIs are mandatory 10-digit identifiers for healthcare providers, ensuring standardization across health care providers, plans, and employers.
Streamline Hospital Privilages
We navigate the complexities of hospital credentialing, leveraging our established relationships and expertise to secure privileges and facilitate re-appointments seamlessly.
Ensure Compliance, Avoid Risk
Our deep understanding of products and business lines across states allows us to navigate complexities, optimize negotiations, and ensure compliance with state-specific regulations.
Data Collection and Verification in minutes, not months
Leverage our in-house technology for real-time provider data verification straight from primary sources. Our CAQH integration standardizes application information and auto-rosters each provider’s data, ensuring compliance without manual input or repeated entries.
Contract Negotiation and Payer Enrollment
Secure favorable terms and rates with payers/insurance companies. We handle application submission, ensuring accurate completion and attachment of all required documentation.
Timely Monitoring and Follow-Up
Navigate the credentialing process, typically lasting weeks or months. Our team monitors progress, follows up with relevant parties, and keeps you informed of application status.
Experience ongoing end-to-end support
Synova provides comprehensive, ongoing support. We track licenses, monitor expiration dates, and send automated renewal notifications. This ensures accurate documentation and maintains ongoing compliance, minimizing risks associated with expired licenses.
Provider credentialing is the process of verifying the qualifications and background of healthcare professionals. This includes confirming licenses, education, training, certifications, malpractice coverage, and other criteria required by insurance companies and healthcare organizations.
Yes, a key part of our service is payer contract review and negotiation on your behalf. Our team analyzes proposed contracts to secure fair reimbursement rates, reasonable terms, and protect your interests.
Credentialing ensures healthcare providers meet payer and regulatory standards. It allows them to be reimbursed for services rendered and participate in insurance networks. Proper credentialing is essential for revenue cycle management.
Our team handles multistate credentialing and ensures you meet all licensure and payer enrollment requirements in each state.
Our credentialing experts will gather and primary source verify all your credential data and documentation. We handle application preparation, submission, and follow-up for initial credentialing and re-credentialing with all payers and hospitals.
Absolutely, we can take over all new and existing credentialing workloads from your team or provide credentialing from the ground up.
Contracting is the process of negotiating and establishing contracts between providers and payers. These legal agreements outline reimbursement rates, approved services, and other terms.
We offer straightforward, flat-rate pricing packages customized for your speciality, provider volumes, and credentialing needs.
Accelerated Outcomes
Value-driven Collaboration
Compliance Assurance
Bring a change to your Healthcare Operations
A partnership with Synova gives you an inherent:
Connect with our experts for a quick analysis and possibilities.