DESIGN REVIEW · Proposed service copy · Consultation form is a demonstration

For U.S. healthcare practices

Provider credentialing.
MACRA / MIPS support.

Coordinate payer enrollment and prepare for MIPS reporting with a clear plan. Add compliance audit support to identify billing risks early, with complete medical billing and RCM available as needed.

Credentialing, reporting preparation and proactive compliance review.

Two priorities. One practice.

Enrollment readiness.
Reporting readiness.

01
Provider credentialing

Documents, payer applications, follow-up and enrollment status.

Explore credentialing ↗
02
MACRA / MIPS support

Participation review, data coordination and reporting preparation.

Explore MIPS support ↗
Compliance audit support
Identify risks and support corrective action.
Explore audit support ↗
Provider credentialingMACRA / MIPS supportCompliance audit supportComplete RCM support

Our primary areas of focus

Support for enrollment.
A plan for MIPS.

Start with the service your practice needs. Coordinate both areas when provider growth and reporting priorities overlap.

Primary focus / 01

Provider credentialing
& payer enrollment.

Keep provider documentation, applications and follow-up organized as you add providers, locations or payer relationships.

  • Provider and practice document readiness
  • Payer applications and status follow-up
  • Enrollment updates and renewal coordination

A practical view: provider/payer status, missing items and next actions.

Primary focus / 02

MACRA / MIPS
reporting support.

Bring participation review, data coordination and documentation into a reporting plan that fits your practice.

  • Participation and reporting-readiness review
  • Measure, data and evidence coordination
  • Milestone tracking and submission support

A practical view: readiness milestones, open gaps and responsible owners.

Compliance audit support

Identify billing red flags.
Act on compliance gaps.

Review documentation, coding and billing workflows to identify potential risks early and support timely corrective action.

Strengthen your practice's audit readiness.

Proactive reviews help your practice address issues that may lead to payer scrutiny, payment recovery, penalties or federal healthcare program exclusion arising from noncompliance.

Start with an agreed audit scope, document the findings and turn them into practical actions for your team.

Discuss compliance audit support

Explore OIG compliance program guidance

  • Documentation and coding review. Compare an agreed sample of claims with supporting records to identify gaps and inconsistencies.
  • Billing and payer-policy review. Identify recurring errors, unusual patterns and items needing review against applicable coverage and billing requirements.
  • Findings and corrective action. Organize observations, priorities and assigned actions, with provider or staff education where included.
  • Follow-up and monitoring. Track agreed corrections and repeat checks to assess whether identified issues have been addressed.
What your practice receives: a findings summary, prioritized corrective action plan and follow-up tracker. Audit scope and review frequency are agreed for your practice.

How the engagement takes shape

Clear responsibilities.
Visible next steps.

Define the work around your enrollment or reporting needs, then agree on the information, access and decisions required.

01 / REVIEW

Understand your priorities

Discuss provider plans, payer applications, performance year and current reporting workflow.

02 / PLAN

Agree on the scope

Set deliverables, responsibilities, document requirements and authorized access.

03 / COORDINATE

Track the open work

Keep missing items, applications, data gaps and reporting milestones visible.

04 / REVIEW

Confirm the next action

Review status, outstanding decisions and follow-up with your practice.

Broader support for your practice

Need complete RCM?
Connect the whole cycle.

Extend your engagement to medical billing and revenue cycle management, or discuss a full RCM service on its own.

End-to-end RCM support

From claim preparation to payment follow-up.

Coordinate billing, coding, claims, denials and A/R with agreed reporting and practice responsibilities.

Explore complete RCM services ↗

01 / Before the claim

Demographics, eligibility and authorization coordination.

02 / Claim preparation

Coding, charge entry, review and submission.

03 / Payment follow-up

Posting, patient billing, denials and outstanding A/R.

04 / Ongoing visibility

Reconciliation, exceptions and operational reporting.

Visibility for your practice

Know what is open.
Know what comes next.

Agree on status views that connect the work with the next action and the person responsible.

Deliverables and review frequency are defined for each engagement.

  • CredentialingProvider/payer status, missing documents and confirmed effective dates.
  • MACRA / MIPSReadiness milestones, data gaps and supporting documentation.
  • Audit supportReview findings, corrective actions and follow-up status.
  • Practice actionsOpen questions, required approvals and assigned owners.
  • RCM, if includedClaims, denials, aging and payment follow-up priorities.

Before we talk

Questions about
your next step.

Can we engage only for provider credentialing?

Discuss a focused credentialing engagement for your providers, payers and locations. The proposal should define the applications, maintenance work and responsibilities included.

Can we discuss MACRA/MIPS without outsourcing billing?

Yes. A MIPS conversation can begin with your reporting needs and current workflow. A separate scope should identify the preparation, documentation and submission activities involved.

Is MIPS reporting required for every provider?

No. Participation depends on eligibility and the applicable program rules. Confirm your practice's status and reporting pathway for the relevant performance year before setting a reporting plan.

Can you guarantee a payer enrollment date?

Payer processing times, panel availability and document requirements vary. An enrollment plan should track applications and follow-up without promising a payer's approval or effective date.

Can compliance audits prevent penalties or exclusion?

Audits can identify issues and support corrective action, helping your practice manage compliance risk. They cannot guarantee that a provider will avoid payer review, penalties or program exclusion. Decisions depend on the facts and applicable requirements. Findings that may require repayment, disclosure or legal interpretation should be escalated to your practice's compliance lead and legal counsel.

Is complete medical billing and RCM available?

Yes. Discuss end-to-end medical billing, coding, claims, payment posting, denials, patient billing and A/R support alongside these services or as a separate engagement.

Start with your priority

Credentialing,
MIPS, or both?

Tell us about your provider enrollment, MIPS reporting or compliance audit needs. You can also request complete RCM support.

  1. Choose the area where you need support.
  2. Discuss your practice's current status and priorities.
  3. Review the proposed scope and next steps.

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