Provider credentialing and insurance enrollment services
New providers can't bill until they're enrolled, and lapsed credentials stop payments. We handle payer enrollment and re-credentialing from start to finish and follow up until every application is approved.
What our credentialing service covers
Credentialing is slow, paperwork-heavy and easy to get wrong. One missing document can send an application back to the start of the queue. We prepare complete applications, track every one and follow up with payers on a set schedule.
Commercial payer enrollment
Applications to commercial and managed care plans, tracked through to contract and effective date.
Medicare and Medicaid
Medicare enrollment through PECOS, state Medicaid enrollment and Medicare Advantage plans.
CAQH ProView
Profile setup, document uploads, payer authorizations and re-attestation every 120 days.
NPI and group setup
Individual (Type 1) and group (Type 2) NPI registration and linking providers to your group.
Re-credentialing
Renewals and Medicare revalidation started early, so network status never lapses.
Document tracking
Expiry alerts for state licenses, DEA registration, board certification and malpractice coverage.
How long does credentialing take?
It depends on the payer and the state. Many commercial enrollments take 60 to 120 days, and some take longer. Government programs follow their own timelines. We can't control payer processing times, but we can make sure your applications are complete, submitted promptly and followed up regularly, which avoids most avoidable delays.
| Stage | What happens |
|---|---|
| Intake | We collect provider documents and information once and store them securely. |
| Applications | CAQH is updated and applications are sent to each payer you choose. |
| Follow-up | We check status with every payer on a regular schedule and answer their requests. |
| Approval | Effective dates and provider IDs are recorded and passed to billing. |
| Maintenance | Re-attestations, revalidations and renewals are tracked from then on. |
Who needs credentialing support
- New practices getting enrolled with payers for the first time.
- Groups adding new providers who need to start billing quickly.
- Practices adding payers or moving to a new location or tax ID.
- Practices whose credentials have lapsed or are close to expiring.
Frequently asked questions
Can you credential providers in any state?
Yes. We handle payer enrollment for providers in every US state, following each state's Medicaid process and each payer's requirements.
How is credentialing priced?
Credentialing is priced per provider and per payer application, with ongoing maintenance available at a monthly rate. You get a written quote before we start.
Do you help with payer contracts?
We help you review fee schedules and request contract terms during enrollment. For legal review of contracts, we recommend your healthcare attorney.
What do you need from the provider?
Usually a license, DEA, board certification, malpractice certificate, CV with work history, NPI and CAQH login if one exists. We send a simple checklist at the start.
Often paired with provider credentialing
Find out where your practice is losing revenue
Book a free, no-obligation practice review. We look at your claims, denials and A/R and send you a written summary of what we would fix first.