Design

Health Plan Enrollment

Health Plan enrollment program for major and local health plans that focuses on speed and efficiency of on-boarding providers for faster effective dates.

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Professional Liability and Risk Management Services

Independent Insurance Agency specializing in brokerage and risk management services for the healthcare community.

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Credential Verification Services

Credential Verification Organization (CVO) specializing in primary source verification for hospitals, surgery centers, and healthcare networks.

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Compliance Services

Regulatory monitoring and background checks for compliance with State and Federal mandates including CMS Fraud, Waste and Abuse requirements for OIG/SAM/GSA exclusion lists.

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Medicare and Medicaid enrollment Services

Outsourced solution to the changing government payer programs.

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Healthcare Network Services

Consulting and program services for Managed Care Networks including but not limited to Independent Physician Association, Integrated Care Networks, Clinically Integrated Networks, and Accountable Care Organizations.

 

Federal guidelines now require screening of not only the healthcare providers themselves, but also “managing employees” and vendors. This screening includes felony background checks and monthly monitoring of the OIG/GAS/SAM exclusion lists. Non-compliance will result in excessive fines and fees. Fifth Avenue has developed a program to address your office’s needs with these new regulations.

Credentialing with health plans including Medicare and Medicaid has become a time consuming and daunting task. One mistake can cause revenue loss for months of care if the provider is deemed out of network. Managing a provider’s credentials with the payers has become a major part of the revenue cycle management and contracting aspect of health plan networks.

Medical malpractice insurance has become a major part of a healthcare practice’s expenses. Recent trends show that premiums may be on the rise again. Having access to professionals who know the policy information of multiple carriers, as well as a detailed understanding of your practice is the key to managing these changing times.

Fifth Avenue Verification Services is a Credentials Verification Organization (CVO) that provides outsourced verification of provider credentials for hospitals, surgery centers, networks, group medical practices and more.

Fifth Avenue Healthcare Network Services can help your organization create and manage networks. Our extensive backgrounds in network management and wide range of proprietary programs makes us a great resource for growing or adapting your network to a constantly changing marketplace.

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Setting up ACOs, Narrow Networks, Integrated Care Networks, or Independent Physician Associations using the Credentialing Process

May 11th, 2016|0 Comments

For the sake of discussion we are going to wrap up these forms of healthcare organizations into the term Managed Network (MN) to include all forms of providing healthcare as […]