We pride ourselves on our adaptability and commitment to excellence in every aspect of our service. Explore what we have to offer and how we, Pinnacle Credentialing Solutions, LLC, can contribute to your success.
We provide services to new and established providers that have completed the licensing process, including but not limited to:
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Physicians
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Podiatrists
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APRN's
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Physician Assistants
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Physical, Occupational and Speech Therapists
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LPC/LMHC
Provider Credentialing & Enrollment Services
We handle the credentialing and enrollment process for all commercial payors and Medicare, ensuring a smooth and efficient experience.
New Application Submissions – Prepare and submit credentialing applications according to the insurance's specific guidelines for your specialty.
Application Follow-Up Service
We proactively track and follow up on your applications until the process has been completed and enrollment has been confirmed.
CAQH Initial Applications– We complete and submit your initial CAQH ProView profile, ensuring all required information is accurate and up to date for seamless credentialing with payors.
Support for Providers who are members of a delegated entity
While Pinnacle Credentialing Services cannot enter into a delegated agreement. We will provide tailored support to healthcare providers whose credentialing and enrollment is delegated.
Our services ensure a smooth credentialing process while being compliant and meeting all necessary standards. We offer:
Credentialing Documentation Management
Ensuring accurate and timely submission of all required documents, including licensure, certifications, malpractice insurance, and more.
Streamlined Enrollment & Recredentialing
Managing the initial enrollment and ongoing recredentialing process with the CVO to ensure continuous participation in healthcare networks.
CAQH Profile Management
We will maintain CAQH profiles to facilitate faster credentialing and eliminate delays.
Ongoing Credentialing Support
Serving as a liaison between providers and the CVO to resolve any credentialing issues or discrepancies promptly.
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Recertification Services
Credentialing is an ongoing requirement, not a one-time task. Recredentialing (also called recertification) is required every 2 to 3 years to maintain active participation with insurance networks. This process ensures providers continue to meet updated standards and compliance requirements.
Proactive Recredentialing Management
Track and monitor upcoming recredentialing deadlines.
Application Preparation & Submission
Complete and submit all required recredentialing applications according to the insurance's specific guideline for your specialty.
Ensure all provider information is accurate and up to date.
CAQH Profile Management
Update and attest your CAQH profile, ensuring timely recredentialing approval.
Follow-Up & Status Tracking
Regularly follow up with insurance networks and credentialing bodies.
Provide real-time updates on the status of your application.
Resolve any issues or additional requests from payers.
Ongoing Maintenance
Demographic Updates-We handle and submit any changes to your provider details, including but not limited to: Address changes, Tax ID updates, Name changes, Practice affiliation changes, etc.
CAQH Profile Updates & Management – We ensure your CAQH profile remains accurate and up to date with the latest credentials and information. We complete the required re-attestation process to maintain compliance with payors and prevent disruptions in credentialing.
Expiration & Renewal Tracking
We will maintain records of all credentialing documents and renewal deadlines. Notifying you in advance about expiring credentials (medical licenses, DEA, Board Certification and malpractice insurance, etc.).