Credentialing & Payer Enrollment
Every week a provider sees patients before they are enrolled is revenue you may never collect. We run enrollment as a tracked project — sequenced by payer volume and measured to the approval date, not the date an application was sent.
Best time to start: For new hires, credentialing should begin as soon as the offer is signed — not when the provider starts.
What we handle
| NEW PROVIDER ENROLLMENT | ONGOING CREDENTIALING MAINTENANCE |
|---|---|
| Medicare & Medicaid PECOS and state Medicaid |
CAQH Profile kept current and attested |
| Commercial & managed care Networks sequenced by volume |
Re-credentialing & revalidation Payer cycles tracked and met |
| Group linkage Linked before the first claim |
Licenses & documents Renewals flagged before they lapse |
What we track for every application
| Application status | Days since submission | Last follow-up | Effective date | Next action |
What happens after approval
Approval is not complete until the provider is linked correctly, the effective date is confirmed, and billing can begin.
Why applications stall — and what we do
| The stall | What we do |
|---|---|
| Missing or expired document | Expiration calendar for every provider |
| CAQH not re-attested | Re-attestation tracked every 120 days |
| Application sent, never chased | Scheduled payer follow-up until approved |
| Approved but not linked to the group | Linkage and effective date confirmed before billing |
| Credentialing is not one-and-done. Re-attestations, revalidations and expiring licenses never stop — so neither do we. |
Adding a provider? Start the day the offer is signed.
Every week without enrollment is a week of visits you may not be paid for.