Comprehensive Solutions

End to End Credentialing, Expirables Management and Re-Credentialing Solutions for all third party insurance, governmental, and CAQH payers

Expirables Management Solutions to maintain all time-sensitive credentials

Re-Credentialing Solutions for all third party insurance, governmental, and CAQH payers

Quality Assurance teams focused on preventing credentialing application rejections

Experienced Account managers to manage every aspect of the credentialing process

Assessments to identify improvement opportunities

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Credentialing Convergence
Credentialing Diagram

Credentialing and Re-Credentialing Solutions

At Newport Credentialing Solutions, we believe that physician and allied health providers should pursue their passion – providing superior care to their patients. Whether an independent provider, a member of a group practice, a hospital employed provider, or a member of an academic medical center, Newport will work with you to manage every aspect of the physician and allied health provider initial enrollment, re-enrollment and expirables management process.

Newport’s management and credentialing specialists are comprised of seasoned industry experts who have worked across hospital, physician and vendor organizations. Our credentialing managers and specialists have deep experience in all aspects related to provider initial enrollment, re-enrollment, expirables management, delegated credentialing, and Article 28 solutions.

Initial Enrollment Services

Newport’s experienced credentialing experts will partner with you throughout the entire credentialing process. Newport will provide:

  • On-site primary source documentation collection using our safe and secure scanning and indexing solution

  • Rapid data entry into our credentialing workflow software

  • Consolidated application packaging and signature packets

  • Dedicated application follow-up to ensure that the insurance plan is proactively processing your application

  • Ability to escalate the completion of your application to our payer contacts

  • Sophisticated reporting designed to “Age” and track your application through every step of the credentialing process

  • Compilation of all Provider Identification Numbers (PINs) for easy billing system entry

Re-Enrollment Services (For Existing Providers)

For those providers who are up for re-enrollment, Newport will conduct all Re-Enrollment Services. Newport will provide:

  • Conduct all re-credentialing services based on specific insurance plan requirements

  • Populate all required payer re-credentialing applications

  • Conduct 100% Quality Assurance on all re-credentialing applications

  • Package all re-credentialing applications with corresponding provider signature pages

  • Use of UPS, FedEx and/or Certified Mail to track and trend mailed applications

  • Conduct verification that all payers have received the re-credentialing applications

  • Newport will conduct Follow-up on all re-credentialing applications to expedite processing

Expirables Management Services

For those providers who are currently enrolled with all plans and need to have their primary source documents maintained, Newport will conduct all Expirables Management Services. Newport will provide:

  • Newport will conduct all CAQH Re-Attestations for all CAQH payers

  • Newport will update all CAQH provider profiles

  • Expiring document report analysis (e.g., expiring malpractice face sheets, etc.)

  • Billing responses pertaining to provider enrollment questions/issues

Technology

Newport understands that technology + domain experience = improved results. Newport’s advanced credentialing workflow software enables Newport to pro-actively mange every aspect of the credentialing and expirables management process. Newport’s credentialing workflow software enables us to:

  • Centrally store all documentation. Our secure site is maintained with individual subscriber accounts which are authenticated and verified using the highest level of e-commerce protection available

  • Access the most up to date insurance plan applications thereby reducing the risk of denial

  • Utilize mapping technology which maps required data elements to the appropriate fields across all insurance payer applications

  • Quality Assurance tool designed to flag any and all incomplete applications thereby reducing the risk of denial