Medical Credentialing
& Enrollment Services
Fast-track commercial, Medicare, and Medicaid payer contracting. We handle everything from CAQH profile setup and NPI registration to contract negotiations and re-credentialing, eliminating reimbursement delays and administrative burden.
Comprehensive Credentialing & Contracting Services
We eliminate the paperwork and follow-up burden so your physicians, nurse practitioners, and allied health staff can start seeing patients and billing without delay.
Individual Provider Credentialing
Enroll solo physicians, specialists, and mid-level providers (PA, NP, CRNA) across commercial and government insurance networks quickly and compliantly.
Primary source verification (PSV) State license & DEA certification updates Commercial insurance paneled enrollment Medicare PECOS & state Medicaid enrollment
Group & Facility Credentialing
Establish group practice contracts, facility billing credentials, and affiliate newly hired clinicians under your existing organizational Tax ID.
Group NPI & Tax ID payer setup Roster management for incoming/outgoing staff ASC, clinic, & diagnostic center contracting Multi-location facility linkage
CAQH Setup & Quarterly Upkeep
End-to-end management of your CAQH ProView database, ensuring every profile is 100% complete, up to date, and re-attested on schedule.
Complete profile creation & document upload Quarterly re-attestation reminders & execution Payer authorization & access granting Resolution of CAQH discrepancies
Re-Credentialing & Renewal Tracking
Payers require re-credentialing every 2-3 years. We track renewal deadlines months in advance to eliminate unintentional lapses in network participation.
90, 60, and 30-day proactive alerts Payer re-credentialing packet completion Malpractice insurance COI updates CME credits & board status maintenance
Payer Contracting & Fee Schedules
Negotiate favorable reimbursement rates and ensure contracts accurately represent your practice's clinical scope and regional market standards.
Fee schedule analysis & benchmark comparison Payer contract language review Opt-in & participation tier guidance Contract renewal rate renegotiations
Hospital Privileging & Medical Staff
Navigate the strict requirements of hospital medical staff offices (MSO), surgery centers, and healthcare systems for admitting privileges.
Hospital application packet completion Peer reference tracking & collection Procedure-specific privilege documentation Board review timeline monitoring
From Onboarding to Active In-Network Status
Our disciplined 5-stage protocol ensures zero missing documents, aggressive payer follow-ups, and predictable enrollment dates.
Zero-Discrepancy Submission
Every application undergoes double-check audit before dispatch to prevent payer rejection stalls.
Document Intake & Credential Audit
We collect licenses, CVs, diplomas, malpractice insurance, and board certificates. We perform primary source verification and verify all dates and addresses.
CAQH & Portal Preparation
We build or re-attest the provider's CAQH profile, update PECOS, state Medicaid portals, and ensure 100% data alignment across all national registries.
Payer Application Submission
Targeted applications and contract requests are submitted to commercial plans (Aetna, BCBS, Cigna, UHC, Humana) and government programs with all required attachments.
Bi-Weekly Payer Committee Follow-Ups
Our coordinators contact payer enrollment analysts twice every week, preventing applications from stalling in review queues and securing rapid committee approval.
Contract Finalization & Portal Handover
We verify the effective date, fee schedules, obtain provider numbers, and load them into your practice management/billing software so you can start billing immediately.
Enrollment Across All Major Commercial & Government Plans
We maintain established direct channels with insurance provider relations departments nationwide.
Built to Keep Your Clinicians Billing Without Interruption
Avoid out-of-network claim denials, enrollment logjams, and lost clinical revenue.
Accelerated Timelines
By submitting zero-defect applications and actively chasing payer committees, we cut credentialing wait times by 30 to 45 days.
No Expired Licenses
We actively track DEA certificates, state licenses, board exams, and malpractice insurance, alerting you before deadlines arrive.
Prevent Out-of-Network Denials
Never lose claims to provider enrollment denials or retroactive gap periods. We synchronize effective dates with billing schedules.
Complete Data Confidentiality
Secure, encrypted cloud storage for sensitive provider documents including SSNs, degrees, licenses, and liability history.
Transparent Weekly Status
Receive a weekly enrollment progress tracker showing exact status, reference numbers, and expected effective dates for every payer.
Dedicated Credentialing Manager
Work with a single accountable specialist who knows your practice, your providers, and your state-specific regulations inside out.
Common Credentialing Questions
Clear answers to help you navigate provider credentialing and contracting.
Ready to Get Your Providers Credentialed Faster?
Speak with our credentialing specialists today. We will audit your current network status, identify contracting gaps, and accelerate your in-network dates.