Provider Credentialing & Payer Enrollment

Project Description: El Paso Country Hospital District d/b/a University Medical Center of El Paso is soliciting sealed proposals for a credentialing program. The primary objective of a credentialing program is to formally assess, verify, and validate a Provider’s qualifications, education, and professional experience. It ensures practitioners meet established industry standards, safeguards public safety by preventing unqualified individuals from practicing, and limits liability for organizations.
The objective of this Request for Proposal (RFP) is to identify and engage a qualified vendor to provide provider credentialing, recredentialing, payer enrollment, and related technology services that support University Medical Center's (UMC) regulatory, operational, and revenue cycle requirements.
The selected vendor will provide expertise, technology, project management, and operational support necessary to ensure providers are appropriately credentialed, enrolled, and maintained in accordance with applicable federal and state regulations, accreditation standards, payer requirements, and organizational policies. Services shall support timely provider onboarding, recredentialing, payer enrollment, ongoing compliance monitoring, and accurate maintenance of provider records.
UMC seeks a comprehensive credentialing and enrollment solution that improves efficiency, reduces administrative burden, mitigates organizational risk, enhances provider readiness, and minimizes delays in reimbursement associated with provider enrollment activities.
The vendor shall provide and maintain a secure credentialing and enrollment platform, facilitate the migration and management of provider records, support ongoing operational activities, and provide training and knowledge transfer necessary for UMC to assume operational responsibility at the conclusion of the implementation period.