Credentialing is the backbone of a profitable medical practice. Without proper enrollment, even the best care goes uncompensated. Our comprehensive credentialing services remove the administrative burden from your staff, ensuring your providers are fully vetted, paneled, and ready to bill from day one.
Navigating the complexities of payer networks is a time-consuming process that can take anywhere from 60 to 180 days. Any error in your application can reset this clock, leading to thousands of dollars in lost revenue. We mitigate this risk by providing:
Faster Approval Times: We know the shortcuts and specific requirements for Medicare, Medicaid, and major private payers.
Reduced Administrative Burden: Free your front-office staff to focus on patient care while we handle the paperwork.
Continuous Compliance: We don’t just set you up; we maintain your profiles and monitor expiration dates to prevent lapses in coverage.
Maximized Revenue: Expand your patient base by getting paneled with a wider range of insurance networks.
We follow a rigorous, “right-the-first-time” approach to ensure your enrollment moves through the system without friction:
Document Collection & Audit: We gather your medical licenses, DEA certificates, board certifications, and malpractice history, auditing them for accuracy before submission.
CAQH Profile Management: We create and maintain your CAQH ProView profile, ensuring it is properly attested and accessible to all relevant payers.
Primary Source Verification (PSV): We verify your credentials directly with the issuing bodies (medical schools, licensing boards) to meet strict payer standards.
Application Submission & Tracking: We submit complete enrollment packets to your chosen insurance networks and provide weekly status updates.
Contract Negotiation & Review: Once approved, we help you review the participating provider contracts to ensure you understand your reimbursement rates.
Ongoing Maintenance: We handle re-credentialing, address changes, and expiration alerts for licenses and certificates.
Whether you are a solo practitioner starting a new clinic or a large multi-specialty group expanding your team, our services are tailored for:
Physicians (MD/DO)
Nurse Practitioners & Physician Assistants
Physical & Occupational Therapists
Behavioral Health Providers
Dentists & Oral Surgeons
Note: Proper credentialing is a legal and financial necessity. We ensure your practice meets all HIPAA, CMS, and Joint Commission standards, protecting you from liability and claim denials.
