Provider enrollment
New providers, new locations, new payers. We handle every application from start to approval.
Provider enrollment, CAQH upkeep, payer applications, and re-credentialing handled end-to-end. We do the paperwork so you can see patients.
One specialist. One workflow. One enrollment timeline you can actually plan around.
New providers, new locations, new payers. We handle every application from start to approval.
CAQH attestations re-attested, profiles kept current, expirations tracked. Never let one lapse.
Licenses, DEA, malpractice, board certifications. We assemble the packet so payers can't kick it back.
Weekly payer calls. Status logs. Escalations when needed. Your application doesn't sit in a queue.
Three-year renewals tracked automatically. Submitted on time, every time. No gaps in eligibility.
Every step documented. Audit trail kept. NCQA-aligned process. Your credentials are bulletproof.
The honest answers, including the unpleasant ones.
Realistic windows: Medicare 60 to 90 days, Medicaid 90 to 180 days depending on state, commercial payers 60 to 120 days, BCBS plans 90 to 150. Anyone promising 30 days for a new provider with no prior contracts is being optimistic. We submit clean applications quickly so the clock starts on day one, but payer queue time is payer queue time.
CAQH ProView is the universal credentialing database every commercial payer pulls from at re-credentialing time. Lapsed CAQH attestation = paused payments on the date the payer pulls. We monitor and re-attest on schedule, refresh expired documents (DEA, malpractice insurance, board certs), and keep your CAQH profile clean so re-credentialing doesn't get stuck.
Yes. Re-credentialing is where most practices quietly bleed revenue, because if a re-cred lapses, the payer pauses claims until it's resolved, and back-dates rarely happen. We track every payer's re-cred cycle, work the file 90+ days before the deadline, and confirm written re-approval.
Medicare Part B, all state Medicaid programs, BCBS plans, UnitedHealthcare, Aetna, Humana, Cigna, regional commercial plans, Tricare, VA, workers comp, and the major dental insurers (Delta Dental, Cigna Dental, MetLife, Guardian, United Concordia). Specialty panels (DOT exams, FAA medical, behavioral-health-only payers) are routine.
PECOS (the Medicare provider enrollment system) is its own beast. 855I for individual providers, 855B for groups, 855R for reassignments, 855O for ordering and referring privileges. We handle initial enrollment, revalidations every five years, group reassignments, and address changes. PECOS rejections almost always trace to one of three things; we know which.
Yes. Multi-state credentialing is increasingly common with telehealth licensure compacts (IMLC for physicians, PSYPACT for psychologists, NLC for nurses, PT Compact for physical therapists). Each state has its own Medicaid enrollment process and some commercial payers issue per-state contracts. We map out the full footprint and execute in parallel.
Claims pause. Payers either deny outright or hold them for re-cred completion. Some payers retroactively pay once re-credentialing finishes; others write off the gap as the provider's problem. The real cost is patient cancellations because patients can't use their insurance with you. We exist partly to make sure this never happens to your practice.
30-minute free billing audit. We'll surface the leaks (undercoding, denials never appealed, eligibility errors) and quantify the dollars you can recover this quarter.
