Our Services

Contracting Services

Initial Credentialing

We handle your initial enrollment with insurance companies, including commercial payers, Medicare, and Medicaid. We gather all required documents, complete applications, and follow up until you’re fully credentialed.

Health Plan network closed for new providers? We will submit exception requests on your behalf to try and get you into the network.

Credentialing Maintenance

Our ongoing credentialing maintenance service is ideal for practices that want continuous credentialing support without the cost of hiring a full-time staff member. For a fixed monthly fee, we handle recredentialing, expirables tracking, updates, and more.

Credentialing Services

Initial Health Plan Contracting

Need to join new insurance networks? We’ll negotiate and manage the contracting process with payers to help you secure favorable terms and expand your patient base.

Contract Renegotiation Already contracted, but unhappy with your current reimbursement rates? We’ll review your current and renegotiate your existing payer contracts to ensure you’re getting the best possible terms.

Behavioral Health Billing and Aged Receivables Support

Behavioral Health Billing

For behavioral health professionals, we go beyond credentialing. Not only will we help get you in-network with insurance companies, but we also offer billing support services to ensure claims are submitted accurately and payments are received on time.

Aged Receivables Support

Is your practice struggling with unpaid claims? Our team works with all practice types, to review your aged receivables report to identify the reasons for payment delays. For denied claims, we obtain the denial reason and provide actionable guidance so your practice can resubmit a corrected claim—or we’ll submit an appeal on your behalf.

Health Plan and ACO Services

Other Provider Solutions

At FI Consulting, we provide specialized support to Health Plans and Accountable Care Organizations (ACOs) seeking to strengthen their provider networks and enhance compliance. With over 20 years of experience, our team brings deep expertise in network strategy, regulatory requirements, and operational execution.

Our Services Include:

• Network Development & Expansion: Whether launching a new network or growing an existing one, we manage provider outreach, contracting, and onboarding to help you meet strategic growth goals and compliance thresholds.

• NCQA-Compliant Credentialing Policies & Procedures: We develop or refine your credentialing and network management documentation to align with National Committee for Quality Assurance (NCQA) standards—crucial for accreditation readiness and regulatory audits.

• NCQA Accreditation Projects: Our team can support your organization through the full NCQA accreditation process—from gap assessments to documentation development and submission preparation.

• CMS HSD Submission Support: We assist with the preparation and submission of Health Service Delivery (HSD) tables to CMS, ensuring accuracy and compliance with network adequacy standards.

• Custom Projects: Have a unique need or compliance initiative? We offer flexible solutions tailored to your organization’s requirements.

Why FI Consulting?
We combine strategic insight with hands-on execution. Whether you're managing a fast-growing ACO or a health plan preparing for accreditation, we serve as your dedicated partner in achieving network strength, compliance, and operational efficiency.

Customized Solutions Don’t see the service you need? Contact us to discuss your unique project or practice requirements. We’re happy to create a custom solution tailored to your goals.

Examples of Custom Projects We've Delivered:

• Web-Based Onboarding Tools: Designed and implemented interactive new employee onboarding programs for healthcare organizations to streamline training and improve compliance.

• EMR Optimization: Developed custom electronic medical record (EMR) templates aligned with HEDIS measures to support quality reporting and improve documentation consistency.

• Patient Outreach Initiatives: Managed targeted outreach campaigns to:

  • Encourage patients to close HEDIS care gaps

  • Prompt assigned but unseen patients to establish care

  • Re-engage established patients who had not been seen in over a year

• Policy & Procedure Development: Created operational policies and procedures to support clinical, administrative, and regulatory objectives, including credentialing and compliance.

• Risk-Contract Service Fund Reviews: Conducted reviews of service fund utilization under value-based contracts to identify inefficiencies, financial leakage, and opportunities for targeted interventions.

Whether you're a provider, practice group, or healthcare organization with a specialized need, our experienced team can help you implement practical, results-driven solutions.