Payor Discovery Report
pie’s Payor Discovery Report gives you a clear, actionable breakdown of each targeted insurance payor, confirming enrollment status, credentialing pathways, telehealth coverage, fee schedule access, and ongoing maintenance requirements—so you can confidently plan your next steps for payer enrollment.
This report includes:
Executive Summary: Quick snapshot of which payors are ready for immediate pursuit and which require further research.
Enrollment Pathway: Step-by-step instructions for each payor’s application and credentialing process.
Delegated Credentialing: Notes on whether delegated credentialing is available or required.
Telehealth Coverage: Details on telehealth eligibility and billing requirements by payor.
Retroactive Billing Policy: Guidance on backdating claims and effective dates.
Action Required: Specific next steps and documentation needed for each payor.
Fee Schedule Visibility: How and when you can access each payor’s reimbursement rates.
Risk Rating: Assessment of process complexity and potential barriers.
Maintenance & Oversight: Ongoing credentialing, site visit, and revalidation requirements.
Client Action Summary: At-a-glance checklist of action items and ownership.
This comprehensive verification is the next step after your market report & launch plan, removing guesswork and accelerating your successful enrollment with each payor.
Last updated