Introducing MD-Staff MC

Overview

For managed care organizations, provider credentialing and enrollment play a key role in the success of the organization. Unless a provider is credentialed properly and the application is submitted in a timely fashion, you cannot bill the insurance company.

The credentialing and enrollment process involve the collection and verification of provider’s information, using this information to populate application to various insurance companies, and tracking the enrollment process. MD-Staff’s extensive web crawling and online verification capabilities automate the credentialing process for large group of providers saving time and money. Adding to these functions MD-Staff MC incorporates additional features which are unique to the managed care environment such as enrollment, plan participation, and contract management.

MD-Staff MC Features


Additional Features


Enrollment and Network Management

You can enroll a provider or a group of providers. MD-Staff MC tracks provider’s participation and contract expiration.

Track the on-boarding process

You can setup "check list" to track the enrollment process and follow up tasks you need to perform. MD-Staff MC automatically reminds of pending tasks to accelerate the enrollment process.

Provider Directory

MD-Staff MC generates provider directories in a format as required by Medicare. These directories can be posted on your public facing website. In addition MD-Directory can be integrated with your website allowing the public to search providers by specialty, office location and health plan.

Other features include

  • Customizable dashboard to track expiring credentials and pending tasks
  • Web based verification of licenses, DEA, OIG, SAM. Verifications can be performed for one provider at a time or as a batch
  • Verification can be scheduled to run as a background job
  • Verification log to document the verification process
  • Automates the application management process
  • Populates applications from a single data source. The applications can be in PDF or Word format
  • Batch application processing. An application can be populated for one or many providers at one time
  • Customizable checklist to track the enrollment process
  • Provides over 200 management reports and NCQA style directory
  • Provides electronic provider look up which can be embedded into your website


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