Credentialing and payer enrollment are the foundation of medical revenue. Slow or incorrect enrollment delays payments and reduces patient access. Our credentialing team handles the full lifecycle so providers join payer networks quickly and stay compliant.
Common Problems:
Long payer turnaround times
Incomplete CAQH/attestation
Recredentialing misses
Credentialing denials
Lost reimbursement due to wrong payer contracts
Our Solution:
CAQH & payer profile setup
Primary & secondary enrollment
Medicare/Medicaid PTAN support
Contract verification
Recredentialing reminders
Appeals for enrollment denials
Process:
Collect documents (NPI, license, W-9, malpractice, CV)
Complete CAQH & payer applications
Submit and track applications; confirm effective dates
Verify contracted rates and fee schedules
Monthly status reports until completion
Benefits: Faster in-network onboarding, correct payer setup, fewer claim rejections, improved reimbursement rates.
KPIs We Track: Enrollment turnaround time, number of active payer contracts, denial rate due to credentialing errors.
FAQ:
Q: How long does enrollment take?
A: Varies by payer (2–16 weeks); we provide status updates and follow up weekly.
We identify your needs and devise customized solutions as per requirements.
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