Credentialing and Enrollment Services

Advancing processes to improve healthcare delivery

The complexities involved in credentialing, enrollment, and privileging have continued to grow. Yet, these processes are critical to helping ensure that your organization can appropriately bill for services.

BerryDunn’s credentialing professionals are adept at navigating the challenges providers face. As an NCQA-certified Credentials Verification Organization (CVO), we help clients streamline processes with strict adherence to compliance policies and regulatory standards.

Services

Our team of credentialing professionals has expertise in a variety of areas that can help you maximize efficiency and stay compliant.

Credentials Verification Organization (CVO) services

Provider and payer enrollment services

Credentialing consulting
services

Provider privileging

Exclusions and sanctions monitoring

Credentials Verification Organization (CVO) services

BerryDunn has the systems, workflows, policies, and team in place to verify your providers’ credentials thoroughly and accurately. We help clients streamline processes with strict adherence to compliance policies and regulatory standards.

Primary Source Verification
(PSV) services

We provide PSV services for delegated commercial payer agreements and internal privileging.

Continuous monitoring
services

We monitor state and federal exclusion lists, as well as license suspensions and malpractice settlements.

Outsourced MSO
services

Our team has the depth of expertise to manage your Medical Staff Office (MSO) temporarily or over the long-term.

Provider and payer enrollment services

We offer a full array of enrollment services to help you improve efficiency and maintain compliance. From application completion to payer maintenance (CAQH, PECOS, NPPES) and revalidations, we have scalable solutions for organizations of all sizes.

Provider privileging

BerryDunn can complete, submit, and track privileging applications for providers to render services at organizations including health systems and hospitals, Federally Qualified Health Centers (FQHCs), and Ambulatory Surgery Centers (ASCs). This can include developing Delineation of Privilege (DOP) and Scope of Practice (SOP) documents.

Exclusion and sanctions monitoring

We equip organizations with resources to manage credentialing and compliance risks by performing continuous monitoring of federal exclusion lists. These monitoring activities help our clients comply with federal mandates prohibiting healthcare organizations from hiring or doing business with excluded or sanctioned entities.

Credentialing consulting services

Through our first-hand experience as an NCQA-certified CVO serving clients across the continuum of care, we offer a variety of credentialing consulting services to meet your organization’s specific needs.

Our depth and breadth as an organization allow us to partner with you in many areas, including revenue cycle and payer contracting. We can also work with you to build efficiencies with workflows and design your department with the right emphasis and structure.

Meet our professionals

Susan Prior

Principal

Christa Bernacchia

Director of Credentialing

View all professionals

Industries we serve

Industry

Hospitals

Industry

Community Health Centers and Rural Health Clinics

Industry

Medical and Dental Practices

Industry

Long-Term Care, Assisted Living and Senior Living

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Podcast

The Alphabet Soup of Accreditation, Credentialing, and Privileging

As an NCQA-certified Credentials Verification Organization (CVO), we assist our clients by streamlining the process with strict adherence to compliance policies.

Achieving CVO certification from NCQA demonstrates that we have the systems, processes, and personnel in place to thoroughly and accurately verify your providers’ credentials.