Credentialing & Provider Enrollment

We prepare and submit payer applications, set up and maintain CAQH, follow up with each payer until a determination, and track revalidation and re-credentialing dates. We also keep you updated on where every provider stands so nothing stalls silently. We do not grant approvals ourselves; those are issued by the payers and any required boards, and a current state license and active NPI need to be in place before we can enroll a provider.

Yes. We prepare and submit Medicare enrollment through PECOS using the correct CMS-855 form for the provider or supplier type, and we handle state Medicaid enrollments and managed Medicaid plans. For DME suppliers, that includes the DMEPOS supplier enrollment path on the CMS-855S and keeping accreditation and surety bond details aligned with the application. Each program sets its own review timeline, and we follow up until the enrollment is active.

We start by collecting each provider's core data once: licenses, NPI, education, work history, malpractice coverage, and the payer list you want them enrolled with. From there we build or update CAQH, prioritize the payers that matter most to your billing, and submit in waves so the highest-impact contracts move first. You provide signatures and approvals where required, and we handle the paperwork and payer follow-up around them.

We work the way your office already works. If you use a credentialing or PM system with enrollment tracking, we operate inside it so your records stay in one place. If you do not, we maintain a clear provider-by-provider and payer-by-payer status log and report it to you on a regular cadence, so you always have a single source of truth for where each application stands.

Credentialing involves sensitive personal data such as SSNs, DEA numbers, and license details, so we operate under a signed Business Associate Agreement with least-privilege access. Staff access only the records they need for your enrollments, and we follow your internal security and document-handling requirements. We treat provider PII with the same care expected for patient PHI.

DME supplier enrollment leans heavily on the supplier side: DMEPOS accreditation, a surety bond, the DMEPOS supplier standards, and the correct CMS-855S details, in addition to NPI and licensure. Physician and group enrollment centers more on individual provider credentials, CAQH, and linking providers to the group's billing entity. We handle both and keep the supplier-specific requirements straight so a missing accreditation or bond detail does not quietly hold up your enrollment.

We do not publish flat rates because the work scales with how many providers and payers are involved and whether it is new enrollment versus ongoing maintenance and revalidations. After a short consult to understand your provider count, target payers, and specialty, we scope a clear price for the engagement. You will know what is included before any work begins.

You get status reporting at the level that matters: which payers are submitted, which are pending, what each payer is waiting on, and what needs a signature or input from you. We surface upcoming revalidation and re-credentialing dates ahead of time, so you are not caught off guard by a lapse that could interrupt billing. The goal is that you rarely have to ask where a provider stands, because you already know.