FIVE STAGES OF YOUR BUSINESS LIFE CYCLE

Our clients typically do not have the technology, expertise or staff needed to successfully manage the Credentialing Life Cycle. We manage the entire credentialing life cycle for you,  Whether you are looking for Home Health, Behavioral Health, Assisted Living, Adult Day Care, physician credentialing, nurse credentialing, medical staff credentialing, or insurance credentialing, our experts will efficiently and effectively cater to all your credentialing needs. We have a proven record of removing barriers, increasing revenue and reducing denials associated with our detailed and precise credentialing process. 

The result? Clients for life!

During the growth of your healthcare organization, it will go through each of the five stages of the business life cycle, encountering different challenges. We will help you identify the answers to the following questions:

 

What Stage of the business life cycle is your business in?

What Services do you need?

STAGE 1: CONCEPT

The concept stage is the beginning of the business life cycle.

This stage, you are brainstorming ideas on the business you want to start. It will require research, gathering feedback to determine if the idea is worth pursuing as a new business.


SOME CHALLENGES:

  1. Will your new business be profitable?

  2. Is there a market?

  3. What is the Structure of your business?

  4. What resources are needed to be successful?

SERVICES YOU MAY NEED:

  • Research

  • Consultation

STAGE 2: STARTUP


Start up

you have decided the  business idea is worth pursuing and have set up the organization. You have a clear understanding of the services you will offer and have decided to open their doors. During this stage, You may need to tweak your offering to ensure they are profitable, while also meeting the needs of your patient’s.

SOME CHALLENGES; 

  1.  Is market presence established?

  2. Is your patient and referral base established?

  3. Is there sufficient cash flow?

  4. Do you stay out of network or become contracted?

 SERVICES YOU MAY NEED:

  • Payor Enrollment (commercial, Medicare, Medicaid, Medicaid Waivers)

  • Appeals

  • CAQH – New Applications and/or Update Applications & Quarterly Attestations

  • NPI Application(s) and/or update NPI profile(s)

  • Licensing (new)

STAGE 3: GROWING

During this stage, You are either in a growing or a surviving phase. your business is  consistently generating revenue through the addition of new patients or providers, and competition exists. you are either operating at a net loss, or a healthy profit. This is when you look to improve yourr models, systems, revenue and operations. You look to focus on core competencies to control costs.

SOME CHALLENGES:

  1. Is your management team effective?

  2. What is the impact of market competition?

  3. Do you have solid referrals?

  4. Is revenue being maximized?

  5. is there a Increase in the number of denials?

SERVICES YOU MAY NEED:

  • Payor Enrollment (commercial, Medicare, Medicaid, Medicaid Waivers)

  • Appeals

  • CAQH – New Applications and/or Update Applications & Quarterly Attestations

  • NPI Application(s) and/or update NPI profile(s)

  • Adding new service location(s)

  • Re-credentialing providers & managing re-credentialing dates

  • Revalidating Medicare and Medicaid

  • Obtaining copies of Contracts & Fee Schedules

  • Managing contracts & Fee Schedules

  • Fee schedule negotiations

  • Updating Network Directories

  • Licensing (new/renewal)

  • Managing and reporting expirables, including re-credentialing dates,  licenses 

STAGE 4: EXPANDING

During the expansion stage, You have a thriving company and have become established in the industry. You are now ready to expand into new markets whether local, regional or national. you need new sources of revenue and cash flow to finance their expansion.

SOME CHALLENGES:

  1. is there Increased competition?

  2. Entering new and different markets?

  3.  Addition of new services, or providers?

  4. Expanding existing business? Adding locations?

 SERVICES YOU MAY NEED: 

  • Payor Enrollment (commercial, Medicare, Medicaid, Medicaid Waivers)

  • Appeals

  • CAQH – New Applications and/or Update Applications & Quarterly Attestations

  • NPI Application(s) and/or update NPI profile(s)

  • Adding new service location(s)

  • Re-credentialing providers & managing re-credentialing dates

  • Revalidating Medicare and Medicaid

  • Obtaining copies of Contracts & Fee Schedules

  • Managing contracts & Fee Schedules

  • Fee schedule negotiations

  • Updating Network Directories

  • Licensing (new/renewal)

  • Managing and reporting expirables, including re-credentialing dates, licenses

STAGE 5: ESTABLISHED

After successfully expanding, Your businesses are at the top of their industry, established and stable. You have a dominant presence in the market(s) you serve and the growth rate of the business has slowed.

SOME CHALLENGES:

  1. Is there Increased competition?

  2. Are you Entering new markets?

  3. Have you added new services, or providers?

  4. Are you expanding, and maintaining, existing business?

SERVICES YOU MAY NEED:

  • Re-credentialing

  • Quarterly CAQH Re-attestations

  • Updating NPI Profiles

  • Re-validating Medicare/Medicaid

  • Updating Network Directories

  • Managing Contracts & Fee Schedules

  • Obtaining Copies of Contracts & Fee Schedules

  • Fee Schedule Re negotiations

  • Licensing (renewal)

  • Terminating Contracts

 

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