Insurance Contracting and Credentialing for Rural Local Health

Garrett County Health Department (GCHD) seeks proposals from qualified contractors to support rural Local Health Departments (LHDs) in the provision of health insurance contracting and credentialing services for clinicians and programs. Through funding made available under the Maryland Rural Health Transformation Program (RHTP), this initiative will strengthen rural agencies' capacity for Contracting and credentialing with insurance providers. By improving empanelment and billing processes, rural residents will gain increased access to covered services locally, supporting earlier disease detection, improved chronic disease management, and reduced reliance on high-cost acute care. Local Health Departments increasingly provide clinical services that are eligible for reimbursement through Medicaid, Medicare, and commercial insurers. Local Health Departments are essential community providers, serving predominantly low-income, medically underserved individuals. However, contracting and credentialing with payers is often complex, time-intensive, and resource-intensive. GCHD seeks a contractor with demonstrated expertise in: Contracting, insurance provider enrollment and credentialing Payer relations and application processes Contracting with Medicaid Managed Care Organizations (MCOs) and commercial insurance networks