Enrollment

Enrollment means participation. Not everyone who wants to participate can. Mistakes in enrollment cause costly delays and denial.  In some cases, mistakes mean you cannot participate for years.

Medicare requires enrollment. Medicaid and Medi-Cal require it. We know about all kinds of enrollment. We help you update required disclosures, credentialing in managed care plans, contracting with health insurance plans, and with revalidation and requests to update participation information.

We have successfully enrolled all types of businesses and providers.  Whether you are new or changing your enrollment, we can help. Our team handles thousands of filings each year. We use PAVE, PECOS and manual systems to link your information with programs that need to verify that you are eligible to participate.

If you applied on your own and have been denied, we can sometimes help you challenge the denial.

If you are unsure how participation or a decision not to participate can impact your business or practice, we can help explain.

If you are buying or selling an enrolled business, we can help you understand what enrollment filings will be required.

We can explain what you need for onsite visits and inspections. We can help answer questions raised at these visits.

We can help you enroll with:

• Medi-Cal

• Medicaid

• Medicare

• Children’s Health & Disability Prevention Program (CHDP)

• Every Woman Counts / Breast Cancer Early Detection Program

• Presumptive Eligibility (PE)

• Family PACT

• Vaccines for Children

• Shared Savings Programs for Accountable Care Organizations
   

We have successfully enrolled:

• Physicians

• Clinical laboratories (CLIA-certified and CAP accredited)

• Pharmacies

• Dentists

• Physical Therapists

• Non-emergency Transportation Providers

• Ambulance Providers

• Home Health Agencies

• Hospice Providers

• Risk bearing organizations (RBOs)

• Independent physician/practice associations (IPAs)

• Telehealth providers

• Federally qualified health centers (FQHCs)

• Durable medical equipment providers (DME)

• Prosthetic and orthotic providers

• Behavioral and mental health providers

• Chiropractors

• Nurses, nurse practitioners, birth centers & nurse midwives

• Physician assistants

• Ambulatory surgical centers

Licenses, NPIs, Permits, Certificates and Registrations.

You need them to operate and to get paid.
Sometimes you need more than one.
Some are local.
Some require a fee.
Some can be done online.
Some are public information.

Our team works with you to identify what you need. We help prepare the applications. We update databases to show your information for those  who need to verify it.