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ZETTARCM is an industry leader with innovative technology and an expert team. We are a complete Revenue Cycle Management solution that streamlines reimbursements and delivers remarkable results.
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ZETTARCM is an industry leader with innovative technology and an expert team. We are a complete Revenue Cycle Management solution that streamlines reimbursements and delivers remarkable results.
On paper, your credentialing team appears to be busy. Applications are submitted. Provider profiles are filled. Licenses are verified. It all feels like progress until the denials start rolling in, and suddenly, that “approved” provider can’t bill a single telehealth session.
Here’s the reality no one told you: telemedicine and telehealth credentialing isn’t just credentialing with a webcam. It’s an entirely different compliance universe. They flag your app if it’s missing platform validation. They pause approvals for cross-state care. They auto-deny if your taxonomy, service location, or modifiers aren’t virtual-ready.
Not all virtual care is equal. Some payers won’t approve audio-only visits. Others require specific documentation for asynchronous services. We align your credentialing files to reflect how care is actually delivered, in detail.
It’s no longer enough to say “Zoom” or “EHR-integrated.” Some payers demand proof of HIPAA compliance, telehealth capabilities, and bandwidth quality. We prepare and submit tech validation the way payers want it.
Cross-state care equal to different payer rules. If your documentation doesn’t show the correct practice location (even virtually), approvals stall. We credential telemedicine providers with full attention to state, payer, and patient coverage territory.
| Credentialing Layer | How ZETTARCM Handles It |
|---|---|
| Payer-Specific Telehealth Definitions | We pre-load credentialing logic by payer contract. Each file is mapped to the exact reimbursement policies of your active payers. |
| EMR + Platform Integration Validation | We include HIPAA-compliant platform documentation, EMR screenshots, and workflow snapshots in every packet, tailored to each service line. |
| Mixed-Privilege Scenarios | We credential for facility-based and remote-only settings in the same provider file, ensuring accurate privileging whether they’re on campus or off-site. |
| Modality-to-Modifier Mapping | We align each provider’s scope with billing-ready documentation, including 95, GT, FQ, and GQ modifiers, as well as payer-accepted justifications. |
| State-by-State Licensing | We validate cross-state delivery models using IMLC triggers, local license rules, and payer credentialing timelines per geography. |
Most credentialing workflows look efficient on the surface: documents collected, applications submitted, follow-ups underway. But until a provider is payer-approved and billing-ready, none of it translates into real care or revenue.
We collect provider credentials, verify their scope of services, and map them to delivery models — video, audio-only, or asynchronous — along with the platforms used to deliver care.
We build or update each provider’s CAQH profile with verified telehealth taxonomies, malpractice details, and practice locations aligned with payer policy.
Our team initiates license verifications, files new applications where needed, and fast-tracks IMLC participation for multi-state credentialing coverage.
We generate custom enrollment files for every active payer, pre-tagged for service modality and delivery platform, reducing edit requests and rework delays.
Approved credentials are logged, provider statuses are updated in your systems, and billing teams are cleared to submit clean, compliant claims.
Credentialing Built for Modality, Not Just Specialty: We credential based on what your providers actually deliver. Whether it’s real-time video, audio-only, or asynchronous models. Each file is structured for the care type, not just the provider role.
Every Payer’s Telehealth Definition, Pre-Mapped: Blue Cross, Aetna, Medicaid — they don’t agree on what qualifies as “telehealth-ready.” We build credentialing packets mapped to each payer’s virtual care definitions, nothing generic, nothing flagged.
Licensing Aligned to Remote Care Models: From IMLC activation to state-level supervision rules, we track licensing down to patient geography, provider location, and service delivery method.
Platform Validation That Clears Approvals, Not Just Boxes: We don’t just list your platform. We validate it with BAA documentation, HIPAA screenshots, and integration specs that meet payer policy.
Don't just take our word for it - see what our happy clients are saying about our personalized medical billing services.
ZETTARCM is an industry leader with innovative technology and an expert team. We are a complete Revenue Cycle Management solution that streamlines reimbursements and delivers remarkable results.