When Medical Provider Resources (MPR) opened its doors in 2011, it was well-equipped to provide physician verification services with a long history of excellence in staff credentialing expertise. But its expansion into provider enrollment services has elevated MPR’s best practice support to a whole other level.
In addition to its foundational verification services, MPR specializes in processing applications for every type of insurance enrollment, a tedious process that often frustrates physician practices and can dig into a physician’s bottom line.
“Insurance enrollment is important to providers, because they need to get reimbursed for their services,” CEO Vicki Bond said. “If these enrollments are not done correctly or fully, it costs the group money. You’ve got to have the enrollments done correctly to avoid out-of-network reimbursement.”
Many physician practices are enrolled in at least a half-dozen commercial plans, including Blue Cross and Blue Shield, Aetna, ProviDRs Care Network and Health Partners of Kansas. Then there are the federal plans including Medicare, the Kansas Medical Assistance Program and KanCare.
And most physicians don’t wish to turn away patients whose insurance coverage doesn’t mesh with the practice’s contracts.
“MPR removed our frustration of staff trying to keep up with something that MPR can handle with the knowledge and people to do a professional job,” said Jyl Nokes, COO of Heart of Kansas Family Health Care.
It’s no secret that insurance enrollment with government and commercial payers is challenging, and can lead to enrollment problems and denials of claims. Each insurance company also has different re-enrollment schedules, and there’s the additional challenge of enrolling in the Council for Affordable Quality Healthcare (CAQH), the universal credentialing data source for insurance enrollment that has to be updated and re-attested to every 120 days.
“MPR has the expertise to navigate through enrollment forms and requirements for so many different insurance companies, which saves us time and frustration,” said Marla Ross, credentialing coordinator for Cheyenne County Hospital.
Bond said MPR’s job is to make these processes as painless as possible, going beyond enrollments and re-enrollments and keeping an eye on everything from license expiration to DEA renewals, and then taking care of it. MPR also keeps tracks of all CMEs and clinical privileges.
And MPR does it for less cost than most practices would pay to hire someone to do it, Bond said.
“Physicians and their practice managers don’t have time to babysit insurance companies,” she said. “We try to take the administrative burden off those providers so they’ve got more time for patient care.”
MPR works statewide, handling about 170 contracts with hospitals and physicians. Although MPR began nine years ago, its team has been on the forefront of credentialing and enrollment for decades. Bond helped start the Kansas Physician Information Verification Program, which became part of MSSC in 1992, and then founded Medical Staff Services, an Andover-based medical staff verification company. Those organizations merged when MSSC purchased Bond’s company in 2011 to expand its physician services repertoire. That’s when MPR began offering additional services such as provider enrollment, and offering expanded services to advanced practice providers.
“That is what MPR exists to do – provide more efficient services to the providers in our community,” Bond said. “I know physicians hate paperwork. Our goal is to make it as easy as possible for them.”
MPR can be reached online at medicalproviderresources.com.