PHM Network | Credentialing Verification

Credentialing Verification Services

Initial Credentialing
Re-Appointment & Re-Credentialing
Pre-Populated Application Services
Continuous Credentialing Services
Rush Services
Status Reports and Monthly Updates

Our Customers Include:

Credentialing Departments
HMO’s, PPO’s, PHO’s, MSO’s, and IPA’s
Home Health Agencies
Hospitals and Hospital Systems
Managed Care Organizations
Medical Staff Offices
Outpatient Surgery Centers
Payer-Sponsored Networks
Medical Centers and Clinics
Provider-Sponsored Networks

Pre-Populated Application

Using PHM’s standard application form, applications can be pre-populated from PHM’s database to reduce Provider errors and time required to fill-out forms

Continuous Credentialing

Tickler System Provider for monthly updates of time-sensitive documents
Tickler System Updates Medical License, DEA and CDS Certificates, and Malpractice Coverage

“Rush”

Files are completed in 30 days or less

Credentialing Verification Services Overview

Professional Healthcare Management, established in 1994, addresses the credentialing needs of various managed care organizations, hospitals, and other health care entities.

The verification process begins with a practitioner receiving and completing a Texas Practitioner Application, which is available in both hardcopy and electronic template. The form collects critical information regarding education, training, board certification, licensure, hospital privileges, and malpractice insurance. The form also asks necessary questions related to licensure sanctions, medicare/medicaid sanctions, felony convictions, and malpractice claim history. The information collected is then entered into the PHM Network Credentialing database and primary source verified including a query to the National Practitioner Data Bank. All information is held highly confidential, according to Professional Healthcare Management's strict security policies.

The information housed in the Credentialing Database allows Professional Healthcare Management to provide preprinted forms, applications, and reports. This capacity frees the practitioner from spending valuable time completing multiple forms/applications and decreases duplicative efforts. At recredentialing, the use of a preprinted application or profile means that the practitioner need only review, update, and attest to the information originally provided on the application.

Professional Healthcare Management verifies practitioner's credentials using criteria that is compliant with the National Committee on Quality Assurance (NCQA) and the Joint Commission on Accreditation of Hospitals (JCAHO).

Professional Healthcare Management routinely supports the credentialing and privileging processes that take place in all entities and aims to reduce duplicative efforts and improve the verification process. Contracts with other clients may be establshed on a case-by-case basis.

For more information on how Professional Healthcare Management can reduce your time by working with your organization to complete this tedious task, please call 866-480-1612 and one of our agents will be happy to assist you or send us an email.