ProEnrollment LLC vs PayerReady Credentialing

What should you compare for proposal scope, handoffs and status visibility?

A practice comparing online enrollment workflows and ongoing support should compare proposal scope, handoffs and status visibility using the same provider and payer information in each proposal. Use an open application with a payer request for a correction as the demo case. Ask how the provider receives alerts, who sends the correction and how the final status can be exported.

How to compare proposal scope, handoffs and status visibility

Use an open application with a payer request for a correction as the demo case. Ask how the provider receives alerts, who sends the correction and how the final status can be exported. PayerReady’s published service information

What to verify about owner of payer corrections

Use a single representative file in both discussions. Record how each proposal handles owner of payer corrections and which named role owns the handoff. PayerReady describes provider credentialing and payer enrollment services. Confirm how the proposed service handles your payer mix and open cases.

How to review evidence of submission and follow-up

What to verifyProEnrollment proposalOther proposal
Owner of payer correctionsRequest written scope and ownershipConfirm included work and documentation
Evidence of submission and follow-upRequest written scope and ownershipConfirm included work and documentation
Maintenance and change requestsRequest written scope and ownershipConfirm included work and documentation
Activation recordsRequest written scope and ownershipConfirm included work and documentation
Fees and exclusionsRequest written scope and ownershipConfirm included work and documentation
Activation recordsRequest written scope and ownershipConfirm included work and documentation

What maintenance and change requests should show

Ask for proof of maintenance and change requests and record any exclusions. The final plan decision and effective date depend on the payer and the specific network product.

For proposal scope, handoffs and status visibility, compare the agreed service scope with the expected payer handoff. insurance contract negotiation · behavioral health credentialing · Compare credentialing approaches · Request a credentialing consultation