Get Credentialed Faster, Contracted Smarter, and Never Miss a Reimbursement Again
A provider who isn't credentialed with a payer cannot bill that payer — every service rendered is revenue lost. A provider credentialed at below-market rates loses money on every encounter. We handle the entire process.
What We Do
We manage the complete credentialing application process — gathering all documentation (medical license, DEA, malpractice insurance, board certifications, NPI numbers, education verification, work history, references), completing payer-specific applications, and submitting with meticulous attention to completeness.
The CAQH ProView profile is the foundation of provider credentialing with most commercial payers. We create, complete, and maintain your CAQH profile — ensuring attestations are completed on schedule (every 90-120 days) and supporting documents are current. An outdated attestation can suspend billing privileges with multiple payers simultaneously.
Medicare enrollment through PECOS and state Medicaid enrollment have unique requirements. We manage both — group practice enrollment, individual provider enrollment, reassignment of benefits, and location additions. For newly joining providers, we identify payers offering temporary billing number arrangements.
Most payers require re-credentialing every 2-3 years. Missing a deadline results in immediate termination of billing privileges. We track every deadline and initiate re-credentialing 6 months in advance. For multi-provider practices, we manage the complete group credentialing portfolio.
Once credentialing is complete, we analyze your fee schedules against Medicare rates, RBRVS benchmarks, and regional commercial data — identifying opportunities where renegotiation could increase your per-encounter reimbursement significantly.
What's Included
Application Management
Complete documentation and payer submission
CAQH Profile Management
Creation, maintenance, and timely attestation
Medicare/Medicaid Enrollment
PECOS, state Medicaid, group enrollment
Re-Credentialing Tracking
6-month advance deadline management
Group Practice Enrollment
Multi-provider portfolio management
Fee Schedule Analysis
Rate benchmarking and negotiation prep
Why This Matters for Your Revenue
Frequently Asked Questions
60-120 days depending on the payer. We expedite by ensuring applications are 100% accurate on first submission, eliminating delays from information requests.
We identify payers offering temporary billing numbers or retroactive credentialing provisions so billing can begin immediately under certain conditions.
Yes. We track every re-credentialing deadline and initiate the process 6 months in advance to prevent any lapse in billing privileges.
Yes, we provide nationwide credentialing services and understand the specific nuances of regional Medicare Administrative Contractors.
Yes, we coordinate facility privileging applications in parallel with payer credentialing to minimize time to full operational status.
Medical license, DEA registration, malpractice insurance certificate, board certifications, NPI number, CV/work history, education documentation, and references.