Your Source for Comprehensive
Medical Facility Credentialing Services

1MedCred expedites patient care delivery and revenue generation for health care providers at hospitals, long-term care centers, skilled nursing and rehabilitation facilities, ambulatory care centers, and other medical facilities. We take pride in being a trusted provider of medical facility credentialing services, ensuring the timely processing of staff memberships and affiliations. In addition to preparing and submitting initial facility appointment applications, we provide reappointment application services as well.

NCQA, CAQH & “No Surprises Act” Compliance Support

Keeping health plans up to date with accurate practitioner and practice demographic information is essential—not only so members can find you and schedule appointments, but also so health plans can process and payclaims quickly and accurately.

The National Committee for Quality Assurance (NCQA)’s realignment of managed care payment standards under the federal No Surprises Act, particularly as it relates to inaccurate provider directory data, has shifted many reimbursement disputes away from patients and into negotiations between medical practices and health plans. For practices, this shift introduces new operational, billing, and compliance risks and underscores the importance of timely, ongoing reporting of provider and practice demographic changes to health plans.

Additionally, the No Surprises Act permits health plans to remove providers from their directories after 90 days if directory information cannot be verified—putting network participation and revenue at risk.

The Council for Affordable Quality Healthcare (CAQH) conducts daily database file feeds based on National Provider Identifier (NPI) records and Tax Identification Number (TIN) combinations. As a CAQH management expert, 1MedCred helps ensure your practice is prepared for directory validation audits and mandatory 120-day attestations by keeping your profiles and listings fully accurate and up to date—reducing the risk of payment delays, disputes, and network termination due to inaccurate directory data.

Partner with Us for Seamless Managed Care and Payer Enrollments

Our medical payer enrollment services involve facilitating initial contract and application processing for:

  • PHO Memberships and Contracted Payer Participations
  • Direct Enrollments with Commercial Insurance Plans
  • Medicare Advantage Plans
  • Government Programs – State and Federal Medicaid and Medicare Programs

1MedCred handles all aspects of data compilation, payer application preparation, CAQH population-to-attestation, and application submission at the group and the individual practitioner levels. We report practice and panel changes, site updates/closures, and staff changes to payers, ensuring your practice remains compliant with state and federal regulatory rules. Our medical payer enrollment services also include health plan reenrollment, recredentialing, and revalidation.

If you are already enrolled with the payers, there is no need to sign up for the full complement of services. You can contract with 1MedCred just for our monthly CAQH profile maintenance carve-out service. This includes maintenance of provider profiles to satisfy CAQH’s 120-day attestation requirements – you send us needed updates and we’ll take care of the data changes and attestations for you.

Save yourself and your staff valuable time every month to stay focused on your practice and patients. Contact us today for more information.