CREDENTIALING & CONTRACTING
We support IBCLCs in obtaining credentialing with commercial insurance plans that recognize IBCLCs for independent billing — applications, tracking, re-credentialing, and contract negotiation, handled.
Our Services
Credentialing and billing, end to end.
Comprehensive support for International Board Certified Lactation Consultants — from your first payer application to the last reconciled claim.
01
What We Do
CLAIMS & BILLING
Claim submission and tracking, ERA/EOB reconciliation, denial management, and preventive lactation billing expertise — with transparent communication at every step.
COMPLIANCE SUPPORT
Documentation requirement guidance, record retention best practices, and non-covered service form template guidance — within scope, so your practice stays organized and protected.
02
Credentialing, Step by Step
What we handle for you
- Collecting provider information and required documents
- Preparing and submitting credentialing applications to insurance payers
- Managing re-credentialing requirements
- Basic CAQH maintenance to ensure accuracy and completeness
- Tracking and monitoring application progress through completion
- Negotiating and finalizing contracts with insurance networks
- Providing basic compliance support
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Billing That Doesn't Leave You Guessing
Submit & track
Claim Submission & Tracking
Claims submitted through a HIPAA-compliant clearinghouse and monitored from first submission to final payment — nothing falls through the cracks.
Reconcile
ERA / EOB Reconciliation
Every remittance matched against the claim it pays. Discrepancies get flagged and chased, so your books reflect reality.
Fight back
Denial Management
Denials explained in plain language and appealed with documentation and persistence — plus preventive lactation billing expertise that heads problems off before they start.
04
Services Outside Our Scope
Clear boundaries protect everyone.
This section is designed to safeguard you by making sure you have a clear understanding of the services we provide. It safeguards our work by keeping everything compliant and within appropriate professional limits — and it safeguards our working relationship by establishing clear expectations from the outset, as we serve as a third-party credentialing and billing support provider for IBCLCs.
- No clinical care, medical advice, diagnoses, treatment, or patient communication
- No legal, tax, accounting, or compliance representation
- No guarantees of network acceptance, reimbursement, or insurance outcomes
- No practice management, scheduling, staffing, or business operations
- No tech support, EMR/EHR systems, equipment, or marketing services
- No HR functions, payroll, benefits, or employment decisions
- No services for non-IBCLC provider types
- No claim submission without provider approval; no altering documentation
- No guarantees regarding timelines, payments, or regulatory compliance
Ready to get started?
OFF YOUR