Credentialing

Clemson University is seeking a qualified contractor to provide comprehensive credentialing and provider enrollment services for Clemson Rural Health. The successful contractor will provide full-service credentialing and enrollment support for Clemson Rural Health providers and clinics, including provider enrollment, payer credentialing, recredentialing, Primary Source Verification (PSV), expirable monitoring, sanction monitoring, CAQH maintenance, and associated administrative support. The contractor will be required to manage the full end-to-end provider enrollment and credentialing process, conduct Primary Source Verification (PSV), and perform all aspects of provider credentialing and enrollment functions. • The contractor shall provide all labor, supervision, administration, management, systems, technology, and support necessary to perform the services outlined in the solicitation. • The contractor shall function as an extension of Clemson Rural Health operations and coordinate closely with Clemson Rural Health personnel. • The contractor shall maintain strict confidentiality of all information received or accessed in performance of this contract. • The contractor shall comply with all applicable federal laws and regulations, state laws and regulations, health plan requirements, accreditation standards, and industry best practices. • The contractor shall provide regular reporting, including enrollment status reports, credentialing status reports, expirable tracking reports, and sanction monitoring reports.