Contracts Management and Credentialing…

You Deserve More.

PBN helps you Collect and Preserve it.

PBN provides comprehensive medical payer Contracts Management and Credentialing services, including:

  • Contracts Review and Analysis
  • Payer Negotiation
  • Provider Enrollment
  • Annual and Ongoing Credentialing, and
  • Ongoing Monitoring and Follow-up

Contracts Analysis

Who is your advocate with insurance companies?

PBN increases your revenue through contracts review, objective analysis, and negotiation of physician-friendly fee schedules and other contract terms. We provide comprehensive reports outlining:

  • What’s not in your current contracts that should be
  • What’s missing that could benefit you
  • What’s adding unnecessary risk
  • Recommendations for payer negotiations

Removing Barriers to Payment – Negotiations and Credentialing

Payer Negotiations

After your Contracts Analysis, PBN works closely with you and your payers to negotiate better quality contracts and higher reimbursements. PBN’s reputation and long-standing relationships with all major commercial payers help us get past payer reluctance to share inside information about payment policies and allowables that may be of significant benefit to you.

Provider Enrollment and Credentialing

Once you’re set up with PBN, we monitor your network enrollment eligibility as an ongoing service and react quickly to any issues to avoid cash flow disruption resulting from credentialling issues.

A strategic advantage. Credentialing is an insider’s game. PBN’s internal credentialing staff includes four credentialing experts—industry insiders—with contacts and connections to all major payers who know what payers look for on enrollment applications.

Most practices work with 10 – 20 separate payers internally and mirror several changing hospital participation lists. That kind of complexity means credentialing is as much a business strategy as it is about paperwork . . . more of an art than a science.

Why is Credentialing so important?

Medicare Enrollment no longer grants retroactive billing effective dates. Timely enrollment is a necessity in order to capture maximum provider revenue.

Lapsed or errant credentials hurt more than just your practice. Hospitals can bill your patients directly for services that payers won’t cover because they were provided by a physician with lapsed credentials, which can cause added hassles and expense in your practice and to everyone else involved.

Ongoing Monitoring

Payers typically pay 5 – 15% of your invoices "short." PBN monitors payments to contract allowables in fee schedules then helps you appeal judication to secure the full income you are rightfully due.

PBN has saved medical practices literally millions of dollars through contracts management and improved credentialing practices. To learn more about what we can do for you, contact Jonas Heinrich, Manager of Credentialing and Contracting at PBN.