Credentialing & payer enrollment · United States
Medical credentialing services that stop enrollment from delaying revenue
A provider who is not enrolled cannot be paid. We run credentialing and payer enrollment end to end — applications, CAQH, NPI, revalidations and follow-up — so new providers bill on time and existing panels stay clean.
- 50+
- Specialties enrolled
- All 50
- States covered
- BAA
- Signed before data moves
Credentialing errors do not look like errors at first. A payer application sits in a queue for 90 days, a revalidation deadline passes unnoticed, a CAQH attestation expires — and the first sign is a month of unpaid claims or a provider who cannot see patients on the schedule they were hired for.
Our credentialing service treats enrollment as a dated, tracked project rather than a stack of forms. Every application has an owner, every payer has a status and a follow-up date, and every revalidation is on a calendar long before it becomes an emergency.
What our credentialing services include
The scope below covers initial enrollment and the ongoing maintenance that keeps panels active. Nothing here is a surprise add-on — a credentialing service that skips revalidations just postpones the problem.
- New provider enrollment with commercial payers, Medicare and Medicaid
- CAQH profile setup, document management and quarterly attestations
- NPI registry setup and maintenance (individual and organizational)
- Primary-source verification: license, DEA, board certification, malpractice
- Payer application submission and persistent follow-up until effective date
- Revalidation and recredentialing tracking with deadline alerts
- Demographic updates: address, tax ID, ownership and bank changes
- Enrollment-related denial resolution linked back to billing
Why enrollment delays cost more than the fee
Every week a credentialed-but-not-enrolled provider waits is a week of unbillable visits or out-of-network write-offs. The calculator below estimates what a 60- or 90-day enrollment delay costs against a provider's expected collections — it is rarely a small number.
Faster enrollment comes from follow-up discipline, not from shortcuts: complete applications the first time, payer-specific requirements checked before submission, and a follow-up cadence that does not let a file sit.
Connected to billing, not separated from it
Because we also run billing for most credentialing clients, enrollment status and claim status live in the same conversation. If a payer starts denying for 'provider not enrolled', the fix is owned by the same team that saw the denial — not handed between two vendors who each assume the other is handling it.
How we work with your practice
We operate HIPAA-aligned workflows and sign a Business Associate Agreement before any provider or practice documents are exchanged. You receive a status view of every application and revalidation in flight, so 'where is my enrollment?' always has a written answer.
Services included in this work
Frequently asked questions
- How long does provider credentialing take?
- Commercial payers typically take 60 to 120 days from a complete application; Medicare and Medicaid timelines vary by state. Complete, payer-specific applications with disciplined follow-up consistently land at the faster end of that range.
- Can you fix an enrollment that is already stuck?
- Yes. We audit the application status, identify what the payer is waiting on, correct deficiencies and re-establish a follow-up cadence until the effective date is confirmed.
- Do you manage CAQH for us?
- Yes. We build and maintain the CAQH profile, keep documents current, and handle quarterly attestations so the profile never lapses and stalls your applications.
- What happens if a revalidation deadline is missed?
- Payers can deactivate billing privileges, which means unpaid claims until re-enrollment. Our tracking calendar flags revalidations well ahead of the deadline so this does not happen on our watch.
- Is credentialing included with medical billing?
- Credentialing is a separate service, but it is coordinated with billing when you use both — enrollment-related denials are resolved by the same team that works your claims.
Calculator
Estimate the impact on your own numbers
Credentialing delay cost calculator
Every week a provider waits on enrollment has a price. Here is yours.
New providers or providers adding payers.
Average billable revenue a provider generates weekly.
Weeks of delay you expect without dedicated credentialing management.
Revenue protected by on-time credentialing
$336,000
Revenue at risk from enrollment delays — most of it preventable
- Providers enrolling
- 3
- Delay per provider
- 8 weeks
- Revenue protected by on-time credentialing
- $285,600
Estimates use benchmark recovery rates from comparable US practices. Your written analysis replaces these estimates with numbers from your own payer mix.
Local coverage
medical credentialing services in your city and state
Payer mix, Medicaid programme and filing rules change at the state line. Pick your location to see how we handle it, or browse all 51 state pages and 54 specialty pages.
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