HealthSmart recently completed a delegated oversight audit of Primoris Credentialing Network’s credentialing policy and procedures for 2021. An offsite audit of credentialing files to determine compliance was also conducted. The audit result was a score of 100%.
Primoris is a preferred provider enrollment service company in the HealthSmart network. Primoris provides access to a committed Customer Service Team that can help answer questions and address concerns relating to claims, utilization management, and other provider issues. Primoris also has access to exclusive resources such as provider manuals, newsletters, the HealthSmart Clearinghouse, search tools, and a provider portal where members can get member eligibility and claim status information.
HealthSmart is one of the largest third-party administrators in the United States and the premier provider of customizable health plan solutions for self-funded employers. It reduces costs and improves outcomes while treating its members with respect.
Primoris Credentialing Network has 54+ health plan and network provider enrollment options, with 20+ delegation agreements for more streamlined, efficient provider enrollment. As such, Primoris must undergo delegated oversight audits every year.
Delegated oversight audits gauge the organization’s compliance along with payer and accreditor rules such as:
- adherence to accreditor or certifying body standards,
- data handling policies and procedures,
- roster quality and accuracy, and
- data management technology security.
Primoris has passed the Annual Delegation Audit review with another annual audit score of 100%, including the following scores:
- Policy and Procedure Compliance: 100% out of 100%
- Initial Credentialing Compliance: 100% out of 100%
- Recredentialing Compliance: 100% out of 100%
- Area(s) of deficiency: None
Another Annual Audit Score of 100% Lends to Primoris’ Credibility as a Premier Provider Enrollment Organization.
Primoris’ perfect audit score of 100% lends credibility to its reputation as the largest credentialing IPA (independent physician association) in the Midwest and one of the largest in the country. Serving 6,700+ providers for over two decades, the company is more than capable of managing any quality or quantity of provider enrollment requests.
Primoris co-founder Brad Bond, COO, and Donna Gaydos, Director of Data Integrity Management, led audit efforts for the entire Primoris team. Their 387+ years of industry experience serve them and their providers well.
Primoris aims to offer smarter, simpler, and better enrollment holds, considering a spectacular audit score of 100%.
More information about Primoris Credentialing Network
Primoris Credentialing Network is an NCQA Credentialing Accredited company specializing in credentialing and provider enrollment, with 54+ health plan and network provider enrollment options. Primoris is a family member of Fifth Avenue Healthcare Services. Sister companies include 5ACVO (credentialing and primary source verification specialists) and Fifth Avenue Agency (MPLI and medical malpractice specialists).
Primoris Credentialing Network originally published this article here. For more information on Primoris Credentialing Network, please visit PrimorisCredentialingNetwork.com or Contact Us.
