Provider Services

AHS is the current Provider Enrollment, Re-Enrollment, Re-Validation and Update Services Contractor for Maryland, and we have performed similar provider services work for North Dakota, Pennsylvania, Louisiana and Illinois.

Our provider services involve a diverse compilation of services that are specific to each client and include:

  • Provider enrollment, re-enrollment and re-validation services in accordance with ACA requirements;
  • Provider credentialing;
  • Provider outreach and recruitment;
  • Provider network management;
  • Medical record reviews;
  • Provider certification; and
  • Site visits.

AHS has the technical expertise to manage your call center.

Our work with provider services has involved a range of systems. Regardless if the system is a legacy MMIS or a modern modular MMIS, we have the tools, workflows and staffing approaches to meet the operational requirements of our clients. Further, we bring a robust CRM that allows us to provide our clients with deep insight into provider enrollment statistics, regardless of the capabilities of the state MMIS.

Most of our work with providers involves provider call center services and we have achieved several impressive statistics for our clients including:

  • Supported providers in the roll-out of a new health care delivery system in a manner that was completely seamless to consumers.
  • Completed monitoring requirements for 100% of providers under our purview.
  • Achieved impressive performance levels relative to prior contractors; in one contract, we reduced the average-speed-to-answer from over 40 minutes to under one minute.

“The only way to do great work is to love what you do, and I love working for Automated Health Systems!”

Michael Williams (TN)