Credentialing

Physician Credentialing
Done Right, Done Fast

We manage every step of provider enrollment — CAQH setup, Medicare/Medicaid enrollment, commercial payer applications, and contract negotiation — so your providers can bill from day one.

60
Days Medicare (avg)
150+
Payers We Work With
100%
Application Tracking

Credentialing Delays Cost You Money

Every day a provider is not credentialed is revenue your practice cannot bill for. Credentialing is notoriously complex — each payer has different requirements, timelines, and documentation standards. One missing document can restart the entire process.

Our credentialing specialists manage the entire lifecycle: gathering provider documents, setting up CAQH profiles, submitting applications to all required payers, and following up relentlessly until approval. We also renegotiate contracts when payers offer below-market rates.

A new provider delayed 90 days in credentialing costs a typical practice $30,000–$90,000 in unbilled revenue. Our team minimizes delays through proactive follow-up and payer relationships.
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What's Included

  • CAQH ProView setup and quarterly attestation
  • Medicare and Medicaid enrollment (Part A & B, state programs)
  • Commercial payer applications (BCBS, Aetna, UHC, Cigna, etc.)
  • Hospital privileges application support
  • DEA and state license verification
  • Payer contract review and rate negotiation
  • Re-credentialing and expiration tracking
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How Our Credentialing Service Works

Every detail handled by certified professionals — so you can focus on patient care, not paperwork.

CAQH Profile Management

Complete setup and ongoing maintenance of your CAQH ProView profile, including quarterly attestation reminders so your profile never lapses.

Medicare/Medicaid Enrollment

CMS 855 and PECOS enrollment managed from start to finish, with NPPES NPI registration and state Medicaid applications as needed.

Commercial Payer Applications

Applications submitted to all required commercial payers simultaneously, with dedicated follow-up at every stage.

Contract Negotiation

We review payer contract fee schedules and negotiate rates on your behalf — many practices leave 10–20% on the table with default rates.

Expiration Tracking

We track all credentialing expiration dates — licenses, DEA, malpractice, CAQH — and alert you 90 days in advance for seamless renewals.

Hospital Privileges

Support for hospital medical staff applications and privileging, coordinated with primary payer credentialing for a streamlined process.

Our Process

How We Get You Paid Faster

A proven, systematic process that maximizes collections at every step of the revenue cycle.

Document Gathering

We collect all required provider documentation: licenses, DEA, malpractice, CV, and attestations.

CAQH & Profile Setup

CAQH profile created or updated; primary source verifications completed with all required entities.

Payer Applications

Simultaneous applications submitted to all required payers with customized packages per payer.

Follow-Up & Approval

Weekly status updates, proactive follow-up with payers, and notification upon each approval received.

Frequently Asked Questions

Common questions about our credentialing services from healthcare providers nationwide.

Medicare typically takes 60–90 days; state Medicaid varies from 30–90 days; commercial payers range from 60–180 days. We begin all applications simultaneously to minimize wait time.

Providers can see patients as self-pay or under a participating provider arrangement while awaiting approval. We advise you on the best approach to minimize revenue loss during this period.

Yes. We track all credentialing expiration dates and initiate re-credentialing applications 90–120 days before expiration to ensure continuous payer participation.

Yes. We review your current contracted rates against Medicare fee schedules and market benchmarks, then negotiate with payers for higher reimbursement — particularly effective for new provider applications.

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