Coventry Provider Credentialing Services

Participate in something bigger! Do you want to be a part of one of the country’s largest networks? We can assist you. The advantages of participating in workers’ compensation, auto insurance, or both are numerous. You’re the one we’ve been looking for. At Coventry, we are always on the lookout for high-quality providers who can effectively treat a wide range of injuries. If you’re interested in getting people back to work, play, and life, we should talk.

Coventry Provider Enrollment Services

Get Access to Your Data

If you’re looking for Provider Manuals, a list of Coventry clients, or a bill status, our provider portal coventryprovider.com has everything you need.  If you do not know the password, please contact us at 610.696.3720 for assistance. Here, AWCA providers can obtain a password-protected client list.

Find a Service Provider

Are you wondering which facilities, specialists, or ancillary providers you should contact? Our provider search engine takes the guesswork out of the equation.

Updating Your Information/Finding a Provider 

Search for your name or practice on the site to update your Provider Demographic Information.

What are your biggest roadblocks? 

  • Payment contracts that are ineffective
  • Complicated reconciliation procedures
  • Basic understanding of Federal and Coventry billing regulations
  • Tripwires in Credentialing
  • Every year, there is a change in the existing plan and the addition of new plans

 

How to improve the performance of your contracts

There is unquestionably a power disparity between insurers and healthcare providers. Payers have the advantage. Our contract negotiation specialists in Coventry tip the scales in your favor. Because well-managed contracts will not only protect your revenue stream, but will also provide long-term financial benefits. RVU valuations are performed by us. By reviewing EOBs, our contract negotiation team examines payments for individual services. We mine internal claims data and examine denied/rejected claims carefully. It’s a good idea to discuss payment issues right at the negotiating table. This, more often than not, reduces denials and ensures that our clients walk away with better contract clauses this time.

It is critical to understand the payer’s profile in order to negotiate a successful contract. We certainly know what works after more than a decade of contract negotiations with Coventry. Contract negotiation is more than just requesting lower rates. It’s a chance to talk about new insurance products and plans, risk-sharing models, changing payment regulations, and payer-employer affiliations. That is why you need someone to handle your negotiations, such as our credentialing services, who has a long working relationship with AmeriChoice.

 

You Can Do The Following With Our Coventry Contract Negotiation Services:

  • Receive reasonable remuneration for services rendered
  • Reduce contractual fees.
  • Improve your rates for high-paying CPTs.
  • Put a stop to a payment model that provides more benefits.
  • Maintain compliance with your state’s AmeriChoice payment regulations.

 

 E-Billing 

If you are a provider looking to transition away from paper billing, please call our clearinghouse Solutions at 866.269.0554 for more information.

Provider Information for MPN

Participate in Coventry 

Call 800.937.6824 to begin the process of joining one of the nation’s largest work comp networks.

If you are in Texas, please call us rather than using the online form. 800.937.6824

If you live in New York, you can apply online by clicking here.

To learn more about the networks we offer, please visit our network solutions page.

Automatic Channeling 

Although auto insurance payers may not always have the opportunity to actively direct injured parties to participating providers, injured parties may find you in a variety of ways, including through their employee benefits plan, after having previously been treated by you, locating you through an online provider directory or toll free number, or through the recommendation of a trusted associate or family member.

Benefits of Coventry Credentialing Services

Ensure that quality is maintained.

As previously said, the medical credentialing procedure ensures quality in the healthcare industry. It’s a way of medical industry evaluation that helps to ensure that the medical community’s quality standards are continuously met for the sake of patients. In order to keep costs down, insurance companies prefer to give preference to medical doctors and practises who have proved expertise in their fields.

Patient safety must be maintained.

Credentialing ensures that practises and physicians have the experience and abilities needed to perform treatments on patients, which helps to preserve patient safety. The procedure aims to lessen the risk of medical errors caused by inexperienced healthcare providers. Credentialing helps to reestablish trust between patients and medical practitioners by providing all of this background information. Patients can put their full trust in their physicians’ competence if they know they have the qualifications and merit to be their chosen providers.

Prevent Revenue Loss

Medical offices might lose thousands of dollars in revenue due to delayed or denied reimbursements if they are not properly credentialed. Insurance companies may refuse to reimburse medical practitioners for treatments if they fail to obtain proper credentialing or make mistakes throughout the process. If a medical practise allows a physician to provide services prior to or during the credentialing process, the insurance payer may be entitled to reimburse the treatments

Boost Your Patient Count

Physician credentialing lets medical practitioners to access previously inaccessible patient bases by allowing them to accept health-insurance-covered paints. The vast majority of Americans have health insurance policies; in 2019, 92 percent of Americans were covered by health insurance. This helps medical practises to expand their client base and potentially improve revenue.

Improve Your Practice’s Image

Before committing to a healthcare practise or a physician, more patients are investigating them than ever before. This could entail looking into their background or patient reviews on the internet. One of the most effective strategies to improve your internet reputation is to undergo medical credentialing. When potential patients look up your medical practise online, credentials indicate that it is well-established, respected, and trustworthy.

Improving the Hiring Process

When a physician is benign accreditation, they must through a thorough examination that looks into their personal history, school background, professional experience, and any other qualifications. If your medical practise is employing a qualified medical practitioner, this method can confirm that they are capable of performing the job description requirements

Provide a Competitive Advantage

Medical offices must discover strategies to differentiate themselves in the competitive world of healthcare. Medical credentialing demonstrates to potential new patients that your medical practise employs specialists with relevant experience. Furthermore, being credentialed can assist you in recruiting well-qualified physicians, who are more likely to join a credentialed practise with a larger patient base than one that isn’t. The medical credentialing process gives your medical practise an advantage over competitors in your market and allows you to keep growing.