Physicians DataTrust performs credentialing of all our IPA Physicians and respective Specialty networks. Our credentialing process includes a detailed review of training, residency, education, licenses, and certifications. The credentialing department follows thorough procedures to ensure the legitimacy and experience of our physicians. Every doctor’s profile is compliant with local and national guidelines. We protect client liability by continually monitoring the records of all contracted physicians. Our goal is to ensure any negative legal actions are quickly revealed and appropriately resolved. All non-clinical employees are checked against OIG and EPLS reports on a monthly basis to verify they are eligible for employment in the medical industry. Once credentialed, we provide contracting services for most major HMO health plans.

Our contract staff acts as physician liaisons to negotiate fair compensation for our clients’ medical services. Currently, we contract with almost 20 health plans including commercial, Medicare Advantage, Cal MediConnect, Covered California, and Medi-Cal including:

  • Aetna
  • Alignment Health Plan
  • Anthem Blue Cross
  • Blue Shield
  • Brand New Day
  • Blue Shield Promise Health Plan
  • Central Health Plan
  • Cigna
  • Easy Choice Health Plan
  • Health Net
  • Humana
  • LA Care Health Plan
  • SCAN Health Plan
  • Sharp Health Plan
  • United Healthcare

We also develop and maintain your HMO contracted specialist provider network, hospital affiliations, and ancillary providers. Physicians DataTrust eliminates the hassle of contracting with HMO health plans.