For clinicians going independent.

Going from W-2 to your own practice is fifty decisions in a trench coat. We handle the operational ones so you can keep practicing. Includes entity formation, EIN/NPI registration, CAQH setup, payer applications, malpractice coordination, basic policy library, and the operational scaffolding you need to see your first patient under your own taxonomy.

Deliverables:

• Entity formation and registered agent (Texas filings)

• EIN and NPI-2 registration

• CAQH provider profile build-out

• Initial payer applications across 6–10 commercial and government payers

• Practice operations playbook (scheduling, intake, billing workflows)

• Starter policy library (HIPAA, OSHA, infection control, employee handbook)

• First-90-days operations checklist

Engagement: 12–16 weeks. Best for solo or 2-provider launches.

Initial, ongoing, and re-credentialing.

Credentialing is the work that decides whether you get paid. We manage the application lifecycle for individual clinicians and groups across commercial, Medicare, Medicaid, and TRS-Care payers. Initial enrollment, contract review, fee schedule analysis, re-credentialing cycles, and the pursuit work that gets stalled applications unstuck.

Deliverables:

• Initial credentialing applications (single payer or panel)

• CAQH maintenance and quarterly attestation

• Re-credentialing cycle management

• Payer contract review and fee schedule analysis

• Credentialing tracker and status reporting

• Escalation and pursuit on stalled applications

Engagement: Project-based or monthly retainer.

For health plans and delegated entities.

Whether you’re pursuing initial NCQA accreditation, managing a delegated credentialing program, or preparing for re-survey, the gap between current state and audit-ready is rarely small. We perform pre-survey gap analyses against current NCQA standards, remediate file and policy gaps, and run mock surveys so you walk into the real one with no surprises.

Deliverables:

• Pre-survey gap analysis against current NCQA standards

• Policy and procedure remediation

• Credentialing file audit and remediation

• Delegation oversight program design

• Mock survey with executive readout

• Corrective action plan support

Engagement: 8–24 weeks depending on scope.

From scratch, or repaired.

Building a Credentials Verification Organization is a regulated build, not a checklist exercise. We design the policies, forms, logs, primary-source verification workflows, and audit infrastructure required to operate as a CVO. For organizations targeting NCQA CVO Certification, the build is sequenced toward that endpoint from day one.

Deliverables:

• NPDB Policy Manual

• Credentialing forms package (initial and re-credentialing)

• Master Provider Credentialing Log (MPCL)

• Primary source verification workflow design

• Internal QA and audit protocols

• 16-step CVO development roadmap with NCQA CVO Certification milestones

Engagement: Phase-based, 4–9 months to Certification-ready.

Productized libraries. Editable. Brandable.

Most healthcare entities are running on borrowed, outdated, or AI-spun policies that don’t survive a real audit. Our policy libraries are written to NCQA, CMS, and state standards, organized by domain, and delivered editable for your brand and operations. Pick a library off the shelf or commission a custom one.

Deliverables:

• Credentialing & re-credentialing policies

• Quality management and HEDIS policies

• Utilization Management (UM) policies

• Member rights and grievance policies

• Delegation oversight policies

• HIPAA, OSHA, and operational policies

Engagement: Off-the-shelf libraries available; custom builds 4–8 weeks.

Before, during, and after.

Audits stop being existential when the work is already done. We run pre-audit reviews, support live audit response, draft and execute corrective action plans, and stand up the ongoing monitoring infrastructure that keeps you out of the next finding. Both payer-side and provider-side engagements.

Deliverables:

• Pre-audit gap reviews (NCQA, CMS, state)

• Audit response support and document production

• Corrective action plan (CAP) drafting and execution

• Delegated oversight monitoring program

• Regulatory inquiry response

• Annual compliance calendar build

Engagement: Project-based or annual retainer.