Credentialing and Provider Enrollment services

Properly credentialing and enrolling your providers with your payers is essential to avoid reimbursement delays or denials. We can handle credentialing your providers as well as maintaining their credentials so you don’t have to. We are experienced with credentialing both new practices and individual providers and we are familiar with Medicare, Medicaid, and most commercial payers.

FAQ’s

How long does the provider enrollment process take?

In short, the provider enrollment process usually takes between 90-120 days. There are many complexities in the provider credentialing process and certain providers will require a longer time to become verified.

What does the provider enrollment process look like?

The process should start with understanding your specific network and evaluating the top payers in your market. Once you have decided on the scope of your work you will sign and execute a contract. The application process starts with gathering all of the relevant documents for the insurance company as well as getting contacts at the insurance company that you will be working with. Once you have submitted all the required documents and have confirmation that your application was received you will wait for either further requests until you are informed that your application has been processes and they are ready to receive your claims submissions.

Do credentialing firms have experience credentialing all specialties?

No, most credentialing companies do offer provider enrollment for providers across the United States in many different specialties. To find out how we can help give us a call or send us an email.

Do you have to re-certify?

Yes! Re-certification is extremely important and you need to ensure that you re-certify before your expiration dates.