​WHAT WE DO
Medicaid & Medicare (PECOS/NPPES) Enrollment for Individual Providers and Facilities/Group Practices
End-to-end enrollment support for new facilities, group practices, or individual providers with both Medicaid and Medicare. Services are tailored to each provider type and licensure, ensuring accurate and timely submissions through PECOS and NPPES. Also includes ongoing management, such as Medicaid revalidation every 5 years and Medicare/NPI record updates, to maintain continuous compliance.
MCO Credentialing – Medicaid and Commercial
Expert guidance and management for Managed Care Organization (MCO) credentialing with both Medicaid and commercial insurance plans. Services include initial credentialing, recredentialing every 3 years, and ensuring providers remain compliant with all network requirements.
CAQH Set Up and Management
End-to-end setup and ongoing management of CAQH (Council for Affordable Quality Healthcare) profiles. Ensures provider information is always current for credentialing and insurance purposes, including timely attestation every 120 days.
Systems Development and Implementation
Consultation and hands-on assistance in designing, developing, and implementing customized healthcare administrative or clinical systems to improve operational efficiency and support organizational goals.
EMR/EHR Proficiency
Professional expertise in Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems, providing setup, optimization, staff training, and troubleshooting to maximize practice effectiveness.
Utilization Review (UR) Services
Full-spectrum utilization review services, from initial process implementation to ongoing management and submission. Includes peer-to-peer (P2P) reviews, appeals, and comprehensive support to ensure appropriate care delivery and regulatory compliance.
Data Management​
Reliable management of clinical and administrative data, including secure storage, organization, retrieval, and compliance with healthcare data regulations. Services ensure data integrity, accessibility, and confidentiality for your practice.
Commercial Insurance Credentialing
Full-service support with credentialing for commercial insurance plans. Includes application preparation, submission, follow-up, and ongoing management to ensure providers meet all insurer-specific requirements for network participation.
PECOS and NPPES Management
Assistance with registration, maintenance, and updates in PECOS (Provider Enrollment, Chain, and Ownership System) and NPPES (National Plan and Provider Enumeration System). Services include managing Medicare enrollment records and updating NPI (National Provider Identifier) data to ensure provider information is accurate and compliant.
License Monitoring
Ongoing monitoring of professional licenses and certifications for healthcare providers. Services include tracking renewal dates, providing timely reminders, and assisting with renewal processes to ensure uninterrupted compliance and to avoid licensure lapses.
Policy and Procedure Creation
Development of customized policies and procedures tailored to your organization's needs, ensuring compliance with healthcare regulations and best practices. Services include drafting, reviewing, and updating documentation to support operational consistency and accreditation requirements.
Operational Consulting
Expert consulting to optimize healthcare operations, improve workflow efficiency, and implement best practices. Services include process assessment, strategic planning, and staff training to drive organizational growth and operational excellence.
Compliance Across All Services
All services are provided with a strong emphasis on compliance with federal, state, and industry regulations. This ensures your organization adheres to legal requirements, payer standards, and best practices, minimizing risk and supporting sustained accreditation and operational integrity.
Behavioral Health Billing Specialties
Experienced billing support for:
Detox, Residential Treatment, Partial Hospitalization Programs (PHP), Intensive Outpatient Programs (IOP), Outpatient Mental Health, Outpatient Substance Use Disorder (SUD),
Medication-Assisted Treatment (MAT), Individual, Group, and Family Therapy, Psychiatric Evaluations, and Medication Management
HEATHER STARGEL
MHA, MBA
FOUNDER
ABOUT LOTUS HEALTH
Lotus Healthcare Administrative Solutions was
created to relieve providers, group practices, and
healthcare facilities of the time-consuming
administrative tasks that can distract from patient
care. This service is not only offered to Behavioral
Health providers, but all healthcare providers We
offer a comprehensive range of services that can be
tailored to meet your unique needs, allowing you to
choose the support that best fits your organization.
Let's connect and collaborate to make a positive
impact in the realm of healthcare!