Insurance credentialing/Payer Enrollment

The ProEDI will manage initial and ongoing credentialing with the appropriate payers in the practice region.
As the application processes vary by payer and many insurance providers do not provide retro-authorization, The ProEDI perform pre-insurance verification to check eligibility regarding the particular insurance, requirement for any pre-authorization or referral, whether any copayment has to be collected, if the patient has met the deductible, the amount of co-insurance the patient shares, and whether the patient’s insurance covers the service sought from the provider.