Service Line 2: Provider Operations & Compliance

Provider Operations & Compliance provides ongoing administrative support to help healthcare organizations maintain provider records, payer participation, credentialing requirements, compliance activities, and operational continuity.

 

Administrative obligations do not end after enrollment. Bedrock helps organizations manage recurring requirements, maintain accurate records, and reduce operational risk through structured administrative support.

 

Once a provider is active, Bedrock continues supporting the organization through credentialing maintenance, payer and roster management, compliance operations, and administrative continuity.

 

Revalidation, updates, roster maintenance, and compliance are continuous obligations — not one-time events. OIG’s General Compliance Program Guidance frames compliance as an active operating function requiring infrastructure, monitoring, and ongoing program function. That is the reality this service line manages.

What Is Included

1

Recredentialing calendar management

2

Payer roster and demographic maintenance

3

Revalidations and update workflows

4

CAQH maintenance and attestation management

5

Compliance operations support

6

Training coordination

7

Incident and administrative issue tracking

8

Evidence and audit-readiness support

9

Administrative workflow continuity

Three Retainer Tiers

Operations Management Workflow

Operations & Compliance KPIs

1

Recredentialing tasks completed on time (%)

2

Revalidation tasks completed on time (%)

3

CAQH attestations completed on time (%)

4

Payer roster correction cycle time

5

Incident and administrative issue closure time

6

Audit evidence completeness rate

7

Client retention rate

8

Expansion rate from Core to Managed or Enterprise-Lite

Provider reality:

 One missed recredentialing cycle, stale payer file, or unmanaged compliance issue can create downstream operational disruption that is far more expensive to fix than prevent. Bedrock’s Operations & Compliance service exists to stop those preventable breaks before they happen.

Request Operations Review

Discuss credentialing maintenance, compliance support, payer management, and operational continuity needs.