About.

FQHC and Private physician/ provider credentialing service.
Medical Credentialing and Payer/Provider enrollment are demanding, time-consuming responsibilities. Advance CVO makes them easier, fast, accurate and cost effective. We take care of all the heavy lifting for you!  

HOW WE DO IT

With Advance CVO You stay in compliance.  We offer physician on-boarding and on-going monitoring to new and existing providers. We maintaining constant attention to all facets of credentialing.

WHAT WE OFFER:
  • Licensure for every state, includes re-certifications
  • CAQH reassessment
  • Use of Primary Source Verification
  • Timely Renewal notifications
  • Secure Provider Portal to view your credential status
  • Status reports via e-mail
  • Flat Monthly fee

HOW WE DO IT:
Our experienced team makes your on-boarding experience as simple as possible. It is our goal to have your applications submitted in 5 business days or less.
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After an initial assessment, we will create a customized proposal to fit your needs and immediately implement efficient data management processes to keep you updated on every step of the process.

We send frequent reports and reminders to keep you in compliance.
  • Monthly reports/data sets
  • Provider compliance benchmarking & monitoring
  • Medi-Cal & Medicare CAQH assessments 

After you’re caught up, we’re on standby. Need ongoing help? Our U.S. based friendly credentialing experts will be there for you! A dedicated credentialing expert and account manager will be assigned to your practice to assist you in every step.


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OUR GOAL

Credentialing is a tedious and complicated process and it takes a lot of your time to complete accurately. We have the experience and credentialing software to get your clients credentialed with the correct insurance payers as quickly, accurately, and inexpensively as possible. Let our expert credentialing specialists take care of you, so you can go on to better serve your clients.

Save time and money by having our credentialing specialists complete your client's credentialing applications, submit to payers, and provide you with timely follow-up including ongoing monitoring.
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Stay on track with Credentialing Status Auto-reminders, for both Re-credentialing and Re-validation.
Automatic updates and warnings on upcoming expirations of certificates or other renewable credentials.

ADVANCE CVO  Credentialing is the  solution that your practice has been waiting for!. ​

THE ADVANCE CVO WAY

ACCURACY
Expert credentialing & enrollment staff.

Our seamless on-boarding process integrates with your teams and technology. Paperless enrollment.
Get your FQHC providers credentialed twice as fast using ADVANCE CVO’s U.S. BASED team. We know how to navigate varying enrollment processes. We get all the information we need upfront, so you don’t have to sweat the details​.

EFFICIENCY
We've got you covered.

Fast  accurate credentialing and enrollment.
Advance CVO makes it easier, fast, accurate.  We take all of the heavy lifting.
Advance CVO detail oriented Credentialing experts carefully review all PSV's  and detect potential red flags.
Trust in the accuracy of your provider credentialing information—or let the experts help you avoid the costly consequences of missing red flags. Trust advance CVO.  We’ll  take the entire process off your to-do list.

COST EFFECTIVENESS
No surprise hidden fees.

Transparent fees  no surprises.
​No budgetary surprises _We offer fixed pricing per application.

Common Practice and Terminology

Individual NPI (Type I)- This is your Type I NPI and each provider is required to have one in order to submit claims.  This individual NPI is linked to the group that claims are submitted under.  If you’re a sole proprietor (not billing under a TAX ID/EIN) you will also use this to represent your group.  It is the equivalent of your SSN number when it comes to billing.  This will typically be the first thing you obtain when you’re getting ready to start working in the medical field.  It’s an online application process and pretty straightforward.

Group NPI (Type II)-  Referred to as an organizational NPI or technically as a Type II NPI.  Your type I NPI is for the individual while your Type II is for your TAX ID or for locations under your tax id.  If you have multiple offices, you’ll have one Type II NPI that serves as your primary billing NPI then you’ll have additional NPIs for each location.  Your individual NPI is listed on the claim form along with this Group NPI.  Each provider is linked to the tax id and the group NPI during the credentialing process.  You can find Type II NPIs under 32a and 33a on a standard 1500 claim form.  Your Type II NPI must be applied for once you have your tax id and/or location.

CAQH-  Council of Quality Healthcare.  Online repository used by insurance companies during the credentialing and re-credentialing process.  Each provider is issued a CAQH ID number along with a username and password. It’s important to keep this information securely stored as you need to attest your information every 90 days.  See our article on CAQH credentialing for more information.

Primary Source Verification or Provider Credentialing- many companies will use the information from CAQH to open the process. During this process, an credentialing rep verifies all of the information in CAQH or on the application and analyzes it for mismatched information or gaps in information. They determine if accurate information has been provided. Once all information has been verified, the application works its way through a variety of meetings for approval. Once approved, the application can then be sent to the contracting department for a contract to be created and sent to the provider for signature.

Delegated Credentialing- When groups are large enough(Such as hospitals or universities) the payors can grant an addendum to a contract allowing the group to maintain their own credentialing. This saves time since the payors can be inundated with applications and get backlogged. With delegated credentialing, the group or it’s contracted company are responsible for completing the primary source verification process typically performed by the insurance company.  It’s the responsibility of the delegated entity to ensure that all providers meet the standards as set forth by the insurance company.   Once the provider is credentialed at the facility(such as a hospital) the entity would send each delegated payer a roster(typically once a month)showing all employed providers and any new additions since the last report.
Insurance Contracting- This is exactly what it sounds like. The contracting department drafts a contract specific to the specialty and region the provider works in. The provider reviews and signs or reviews and requests modification until the contract is satisfactory to both parties.  Medicare and Medicaid have their contract incorporated into the application process.  However, Medicaid and Medicare advantage or managed care plans do need to contract your  organization.

Linking- This is when a provider is credentialed, but does not have an individual contract. They are linked to a Tax ID that does have a contract.  The linking process occurs after credentialing and typically takes around 30-45 days.
Loaded- This occurs after a provider has been linked to a Tax ID or a contract has been signed and sent to the payer for counter signature.  This process typically takes 30-45 days to complete.  Once this process is completed, the payer typically issues a letter or an email with the provider’s effective date and provider ID number(if issued).  This is the last step before being able to bill.

Demographic updates- This is slightly different than the standard credentialing because it is used to update the information for a provider or organization that is already credentialed.  These changes take around 30 days to complete dependent upon the payor and their workload.