Commercial Group Contracting Services
Certain insurance carriers require organizations with multiple clinicians to establish a group contract to standardize reimbursement rates across covered billing codes. Group contracting may provide consistency in reimbursement and streamline payer participation for eligible providers within the organization.
Please note that obtaining a group contract does not automatically enroll individual providers. Each clinician must separately complete the credentialing and payer enrollment process before they can participate under the group agreement. Individual provider credentialing and enrollment services are billed separately. Please refer to the Individual Contracting and Credentialing Fee Schedule for applicable fees.
Additionally, some insurance carriers require a minimum number of participating providers before a group contract application will be considered. Group contract eligibility, participation requirements, reimbursement rates, and approval decisions are determined solely by the payer.
Client Obligations
Initial Consultation
The Client agrees to schedule and attend a 60-minute consultation to review practice structure, contracting goals, payer requirements, and necessary enrollment documentation.
Business Documentation
The Client shall provide the following:
Proof of current tax filing status demonstrating good standing.
IRS EIN Assignment Letter (CP 575 or equivalent documentation).
Any additional business documentation requested by the payer during the contracting process.
State Licensing
The Client shall provide:
A copy of the organization's current state license, registration, or other applicable regulatory documentation.
Any state-specific licensing documentation required by the payer, including IDFPR documentation when applicable.
Provider Documentation
For each clinician requiring credentialing and enrollment, the Client shall provide:
A valid Type 1 (Individual) NPI.
A valid Type 2 (Organizational) NPI for the practice entity.
Current EIN/Tax Identification documentation.
A current CAQH ProView application in PDF format.
Copies of all applicable professional licenses, certifications, and supporting documentation requested by the payer.
Any additional documentation required during the payer review process.
Service Fee
Government Contracting Fee: $595
Processing fees may apply.
Please note that payer processing timelines are determined by the individual government agency and may vary significantly based on state requirements, application volume, and payer review procedures. Approval and enrollment timeframes cannot be guaranteed.
Commercial Group Contracting Services
Certain insurance carriers require organizations with multiple clinicians to establish a group contract to standardize reimbursement rates across covered billing codes. Group contracting may provide consistency in reimbursement and streamline payer participation for eligible providers within the organization.
Please note that obtaining a group contract does not automatically enroll individual providers. Each clinician must separately complete the credentialing and payer enrollment process before they can participate under the group agreement. Individual provider credentialing and enrollment services are billed separately. Please refer to the Individual Contracting and Credentialing Fee Schedule for applicable fees.
Additionally, some insurance carriers require a minimum number of participating providers before a group contract application will be considered. Group contract eligibility, participation requirements, reimbursement rates, and approval decisions are determined solely by the payer.
Client Obligations
Initial Consultation
The Client agrees to schedule and attend a 60-minute consultation to review practice structure, contracting goals, payer requirements, and necessary enrollment documentation.
Business Documentation
The Client shall provide the following:
Proof of current tax filing status demonstrating good standing.
IRS EIN Assignment Letter (CP 575 or equivalent documentation).
Any additional business documentation requested by the payer during the contracting process.
State Licensing
The Client shall provide:
A copy of the organization's current state license, registration, or other applicable regulatory documentation.
Any state-specific licensing documentation required by the payer, including IDFPR documentation when applicable.
Provider Documentation
For each clinician requiring credentialing and enrollment, the Client shall provide:
A valid Type 1 (Individual) NPI.
A valid Type 2 (Organizational) NPI for the practice entity.
Current EIN/Tax Identification documentation.
A current CAQH ProView application in PDF format.
Copies of all applicable professional licenses, certifications, and supporting documentation requested by the payer.
Any additional documentation required during the payer review process.
Service Fee
Government Contracting Fee: $595
Processing fees may apply.
Please note that payer processing timelines are determined by the individual government agency and may vary significantly based on state requirements, application volume, and payer review procedures. Approval and enrollment timeframes cannot be guaranteed.
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