Services

Gemini specialises in guiding and executing smooth transitions, swiftly remedying backlog due to inefficiency and ultimately creating an integrated workflow that produces quality / timely work.

Primary Source Verification

Primary Source Verification services for Initial Credentialing and Recredentialing Provider and Organizational (HDO) files to meet NCQA / URAC / CMS / TJC / AAAHC / DNV standards. Verification packages can be customized to meet ANY and ALL Client specific requirements for any Provider / Organization type via standard or expedited service.

Verification Sources (and more)

State Licensure
Sanction History & Detail
FSMB
DEA
State Drug Certificate
Death Master File
NPI
Malpractice Insurance Certificate
Attestation
Hospital Affiliation
Work History
Background Checks
Board Certification

AOA
AMA Profile
Education & Post-graduate Training
ECFMG
National Practitioner Data Bank (NPDB)
Malpractice Claims History
Claims Details
Medicare / Medicaid Sanctions
Medicare Opt-Out
Office of Inspector General (OIG) Exclusion
System for Award Management (SAM)
Peer References

Application Management

Preparation and send out application packets and or CAQH update notification to Providers on behalf of our Clients at both Initial Credentialing and Recredentialing. End-to-end Application Management involves comprehensive tracking and reporting, providing specific follow up details, communication notes and potential network feedback and maintenance (address updates, Provider participation, etc.). Extensive follow up is performed by a dedicated Call Center making actual live calls.

Programming and Pre-population

State Standard / Custom Application

CAQH Integration

Recredentialing Due Date Tracking

Application + Addenda Send Out and Follow Up

Dedicated Call Center

On-Going Maintenance

Sanction Monitoring

Immediate alert of any Provider / Organization identified as a match or possible match from any of the multiple required sanction publications/lookups monitored, along with a detailed Month End Sanction Summary Report, for auditing and oversight purposes.

License Sanction Publication / Look Up

Office of Inspector General (OIG) Exclusion

System for Award Management (SAM)

State Medicaid Sanction / Exclusion

Medicare Opt-Out

Death Master File

Expirables

Tracking and Updating insures providers non-static credentials are kept current in between credentialing cycles. Real-time ongoing reporting of non-static credentials which have been updated and available for download via secure web portal, as well as reporting of non-static credentials that remain expired, along with attempt detail and documentation of follow up performed.

State License

DEA
State Drug Certificate
Fluoroscopy Certificate

Radiography Certificate
Malpractice Insurance Certificate
Board Certification

Data Exchange

Manual data entry can introduce a variety of issues to a medical staff office: Data entry errors; Complex training procedures; Loss of productivity; Increased staff expenses, etc. Gemini offers fully-customizable data exchange services to support your efforts in keeping credentialing, billing, document storage, and EHR systems up-to-date. Gemini’s secure, modern delivery systems and encryption methods ensure the safe delivery of provider data directly to your servers. Delivery schedules and file formats can be customized to meet the complex needs of your organization.