Provider Credentialing & Payer Enrollment
Get your providers enrolled with insurance payers faster — without the paperwork burden. Our credentialing specialists manage the entire process from initial application to approval, cutting typical enrollment timelines by up to 50%.
Every Day Uncredentialed Is Revenue You Can't Recover
A provider who isn't enrolled with a payer can't bill that payer. Delays in credentialing mean delayed revenue — often for 60 to 120 days. We move fast so you start billing sooner.
Faster Enrollment Timelines
Our specialists know each payer's specific documentation requirements, submission portals, and contact points — cutting through delays that bog down in-house teams for months.
Complete Application Management
We gather all required documentation, complete every application form, and submit to payers on your behalf — no incomplete applications, no rejected packets.
CAQH Profile Setup & Maintenance
We set up, complete, and maintain your CAQH ProView profile — ensuring it's always attested, up-to-date, and fully accessible to payers requiring it during credentialing.
Proactive Status Tracking
We follow up with every payer every week — tracking application status, responding to payer requests for additional information, and escalating stalled applications immediately.
Re-credentialing & Re-attestation
Most payers require re-credentialing every 2–3 years. We track all expiration dates and initiate re-credentialing well in advance — so your enrollment never lapses.
Hospital & Facility Privileging
Beyond payer enrollment, we manage the hospital privileging process — coordinating with medical staff offices to secure the clinical privileges your providers need to practice.
Every Credentialing Service Your Practice Needs
From a brand-new provider joining your practice to an entire group re-credentialing cycle — we handle it all.
New Provider Enrollment
Complete enrollment with all applicable commercial payers, Medicare, and Medicaid for new providers joining your practice. We target a 60–90 day enrollment window wherever payers permit.
Medicare & Medicaid Enrollment
Full management of CMS-855 applications, PECOS enrollment, and state-specific Medicaid enrollment — including Type 1 and Type 2 NPIs, reassignment of benefits, and EDI enrollment.
Group & Facility Enrollment
Group practice enrollment, facility credentialing, and billing entity setup — ensuring your practice is enrolled as both an individual provider and a group where required by payers.
Contracting & Fee Schedule Review
We assist in reviewing payer contract terms and fee schedules before you sign — helping you understand your reimbursement rates and flag unfavourable contract language.
Provider Data Management
Maintenance of all provider demographic data across payer portals, CAQH, NPPES, and your internal records — ensuring address changes, NPI updates, and licence renewals are applied everywhere.
Credentialing Status Reporting
Weekly status reports showing every active application, payer response, pending items, and approval confirmations — so you always know exactly where each provider stands.
From Application to Approved — Step by Step
We manage every touchpoint of the credentialing journey — so your team never has to chase a payer or re-submit an incomplete packet.
Provider Intake & Document Collection
⏱ Day 1–3 We collect all required credentials — NPI, DEA, state licences, malpractice certificates, board certifications, CV, and work history. A secure checklist is shared with your team.
CAQH Profile Setup & Completion
⏱ Day 3–7 We create or update the provider's CAQH ProView profile with all documentation uploaded and properly attested — ready for any payer to access immediately.
Application Preparation & Submission
⏱ Day 7–14 Credentialing applications are prepared and submitted to all target payers simultaneously — both online via payer portals and by paper where required.
Payer Follow-Up & Status Tracking
⏱ Weekly Our team contacts each payer weekly to confirm receipt, check status, and respond to any requests for additional documentation — preventing applications from going stale.
Approval & Effective Date Confirmation
⏱ 60–120 Days Once approved, we confirm the effective date and provider ID with each payer and update your billing system — so claims can begin flowing from day one.
Ongoing Maintenance & Re-credentialing
⏱ Ongoing We track all expiration dates for licences, certifications, malpractice, and re-credentialing cycles — and initiate renewals well before any lapse can occur.
Why Practices Outsource to Us
In-house credentialing is time-consuming, error-prone, and pulls your staff away from patient-facing tasks.
We Credential With 100+ Payers
From the largest national commercial payers to regional plans and government programs — we have existing relationships and portal access to over 100 payers nationwide.
UnitedHealthcare
Aetna
Blue Cross Blue Shield
Cigna
Humana
Medicare (CMS)
Medicaid (All States)
Tricare
Molina Healthcare
Centene / WellCare
Anthem
100+ More
Common Questions About Credentialing
Other Ways We Protect Your Revenue
Eligibility & Benefits Verification
Coverage, copays, and deductibles confirmed before the patient arrives. Prevents 30% of denials caused by incorrect insurance data.
Same-Day Claim Submission
Every claim scrubbed and submitted same day as charge entry. 95%+ acceptance rate with major payers. Zero claim backlog.
Denial Management & Appeals
Denials analyzed, corrected, and resubmitted within 48 hours. Root-cause tracking ensures the same denial never hits twice.
Payment Posting & Reconciliation
Line-by-line ERA and EOB reconciliation daily. Every dollar matched, every discrepancy flagged. Audit-ready books, always.
Patient Statement Services
Itemised, plain-language statements delivered by print, mail, or email. Automated 30/60/90-day cycles improve self-pay collections by 40%.
Patient Scheduling Services
Inbound & outbound scheduling with insurance verification at booking. Reduces no-shows by 60% with automated SMS, email, and voice reminders.
Get Credentialed Faster.
Start Billing Sooner.
Our specialists manage the entire credentialing process from start to finish — so you can focus on patients, not paperwork.