Credentialing Services

Medical Credentialing Services and Payer Enrollment

Medical credentialing services that get your providers enrolled with insurance payers and keep them enrolled. We handle CAQH, applications, follow-up, contracting and re-credentialing for physicians, therapists, dentists and other providers, so nobody is left unable to bill.

Medical billing and claims paperwork on an office desk

The Problem

A Provider Who Is Not Credentialed Cannot Bill

Insurance credentialing routinely takes 60 to 180 days, and a single missing document can send an application back to the start of the queue. Meanwhile your new provider is seeing patients you cannot bill for.

Expired CAQH attestations and missed revalidation deadlines cause the same problem for established providers.

01

Applications stall.

Payers return incomplete applications or simply stop responding without follow-up.

02

CAQH out of date.

Unattested CAQH profiles block enrollment and re-credentialing.

03

Missed revalidations.

Medicare and Medicaid revalidation deadlines missed mean payment holds.

04

New providers waiting to bill.

Every week of delay is lost revenue for the practice.

What We Do

What Our Credentialing Services Include

01

Payer Enrollment

Applications with Medicare, Medicaid and commercial payers, prepared and submitted for you.

02

CAQH Management

Profile creation, document uploads and quarterly re-attestation.

03

NPI and PECOS

NPI registration and Medicare PECOS enrollment and updates.

04

Contracting Support

Help requesting and reviewing payer contracts and fee schedules.

05

Follow-Up Until Approved

Regular payer follow-up with status updates you can see.

06

Re-Credentialing and Revalidation

Deadlines tracked and renewals filed on time.

07

Group and Location Enrollment

New practice locations, tax ID changes and group enrollments updated with every payer.

08

Credentialing Tracker

A live view of every application, payer and expiry date.

The Process

How Provider Credentialing Works with Us

01

Intake

We collect provider documents, licences and practice details.

02

CAQH and NPI

We create or update CAQH and NPI records.

03

Payer Selection

We agree which payers to enrol with first.

04

Applications

Applications submitted and tracked for every payer.

05

Follow-Up

Weekly follow-up until approval and effective dates are confirmed.

06

Maintenance

Re-attestation, revalidation and expiry tracking ongoing.

FAQ

Credentialing Questions

Most commercial payers take 60 to 120 days and some take up to 180 days. Medicare enrollment often takes 30 to 60 days. Complete applications and regular follow-up are what keep timelines short.

Provider credentialing is the process of verifying a provider’s education, licences, training and history and enrolling them with insurance payers so they can see covered patients and be paid in network.

Credentialing services typically cost $100 to $300 per payer application, or a monthly fee per provider for ongoing maintenance. We quote based on providers and payers.

CAQH ProView is a database most commercial payers use to collect provider information. Profiles must be kept current and re-attested every 120 days.

You can, but claims may be denied or paid out of network. Some payers allow retroactive effective dates; many do not.

Yes. See our dental credentialing services for PPO network enrollment.

Yes. Our physician credentialing services cover individual doctors and groups, and our doctor credentialing services include CAQH, NPI, Medicare and commercial payer enrollment.

Medical insurance credentialing services enroll providers with health plans so claims pay in network. Insurance credentialing services also include re-credentialing and revalidation, so each insurance credentialing service request is tracked to approval.

Yes. Our medical provider credentialing services cover physicians, nurse practitioners, physician assistants, therapists and dentists.

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Get Your Providers Billable Sooner

Book a call and we will map the payers you need, the documents required and a realistic timeline for each provider.