Provider enrollment & credentialing
Credentialing done right, so your providers bill in-network from day one.
We run payer enrollment, CAQH, revalidations and re-credentialing end to end. No dropped applications, no surprise out-of-network denials, and no revenue stuck behind a 120-day approval nobody chased.
- Price
- $189 per payer, less in bulk
- Plan for
- 90–120 days, by payer
- Payers
- Medicare, Medicaid & all major commercial
- Revalidations
- Tracked before they lapse
What we handle
From a solo provider joining a new group to a full practice adding payers, we own the paperwork and the follow-up: the part that actually eats your staff’s week. Initial enrollment, CAQH, re-credentialing, revalidations, and EFT/ERA setup all sit with one team.
Credentialing is the step most practices underestimate. Until a payer approves a provider and confirms an effective date, the visits that provider sees are hard or impossible to bill in-network. A missing document or an unanswered payer letter can add weeks, so the follow-up matters as much as the application.
What credentialing costs
Priced per payer application, so you pay only for the enrollments you need. The more payers you add, the less each one costs.
Standard rate
$189per payer application.
Up to 7 payers
$150per payer application when you enroll with several payers at once.
Up to 20 payers
$120per payer application for a larger rollout.
Every application includes
- A CAQH ProView check and update
- The payer application, filed in that payer’s format
- Weekly payer follow-up until approval
- The effective date confirmed in writing
- EFT and ERA setup so payments arrive
- No setup fee
Each application covers one provider with one payer. Your price is confirmed in writing before we start.
Not enrolled means not paid.
A provider who isn’t credentialed can still see patients. They just can’t bill for them. Pick a start date and the payers you need to see where the gap falls.
Start credentialing the day you sign the contract, not the day your provider starts seeing patients.
Plan a new provider’s start
13weeks of visits could fall before an effective date
With a start in 1 month, Medicare could be effective in 30 to 90 days and commercial plans in 60 to 120.
Typical ranges with a complete application; commercial plans can need 2 to 6 more weeks to load the contract. Each payer sets its own pace, so we track every application to an effective date in writing.
Start credentialingWho we credential
Every provider type that bills under your group, and the group itself:
- Physicians (MD, DO), including surgeons and hospitalists
- Nurse practitioners and physician assistants
- Behavioral health: psychiatrists, psychologists, LCSWs, LPCs and LMFTs
- Physical, occupational and speech therapists
- Chiropractors
- New groups: group NPI, Medicare group enrollment (CMS-855B) and group contracts
Credentialing by provider type
What changes for each provider type, and what we need from you.
Therapists & mental health
LCSWs, counselors, MFTs, psychologists and psychiatric providers, including behavioral health plans.Nurse practitioners
NPs billing under their own NPI or a group, with collaborative agreements where the state requires them.Physical therapists
PTs in private practice and new clinics: Medicare PTPP enrollment, Medicaid and commercial networks.Home health & home care agencies
New agencies: Medicare certification, Medicaid waivers, VA and EVV, then billing from the first claim.
How long each step usually takes
With a complete application. Every payer sets its own pace, which is why we track each one to a written effective date.
- Documents and CAQH profile1 to 2 weeks, once the documents are in hand.
- Medicare (PECOS)30 to 90 days.
- Medicaid30 to 90 days by state, then each Medicaid managed care plan credentials separately.
- Commercial payers60 to 120 days, plus 2 to 6 weeks to load the contract.
- CAQH re-attestationEvery 120 days.
- Medicare revalidationEvery five years.
How we run your credentialing
Audit & document intake
We confirm NPIs, licenses, DEA, malpractice and work history, and flag anything that will slow a payer down before we ever submit.
CAQH build & attestation
We create or clean up CAQH, upload every document, and keep attestations current so payers never bounce an application.
Payer applications
Medicare (PECOS), Medicaid and commercial applications submitted correctly the first time, matched to each payer’s exact format.
Follow-up until approved
Weekly payer calls and portal checks with escalation: you get a live status tracker instead of a black hole.
Approval & revalidation calendar
Effective dates confirmed, EFT/ERA set up, and every revalidation and re-credentialing date put on a calendar we watch for you.
What we need from you
One clean handoff and we take it from there:
- Individual & group NPI
- Active state license(s)
- DEA / CDS certificate
- Malpractice certificate of insurance
- CV with a gap-free work history
- Practice details & Tax ID / EIN
- Voided check for EFT enrollment
What your practice gets
- In-network on the earliest possible effective date
- No revenue lost to expired or missed revalidations
- A single point of contact who owns every application
- A live status tracker for every provider and payer
- Retro-billing pursued wherever payers allow it
- Clean, maintained CAQH that stops future denials
Credentialing questions
Something else? Call +1 786-788-7313. A credentialing specialist answers.
All questions$189 per payer application. When you enroll with several payers the price per payer drops: $150 each for up to 7 payers, and $120 each for up to 20. There is no setup fee, and your price is confirmed in writing before we start.
Plan on 90 to 120 days for a full set of payers. Medicare and Medicaid usually take 30 to 90 days; commercial payers 60 to 120 days, plus a few weeks to load the contract. Start as soon as the provider’s contract is signed. Our credentialing timeline guide has the payer-by-payer detail.
Yes, but those visits usually can’t be billed in-network. Medicare allows billing for services up to 30 days before the effective date when circumstances kept the provider from enrolling earlier; Medicaid rules vary by state, and most commercial plans pay only from the effective date. We tell you which is which before you schedule.
Individual and group NPIs, state licenses, DEA or CDS certificates, the malpractice certificate, a CV with a gap-free work history, practice details with your Tax ID, and a voided check for EFT. We flag anything that would slow a payer down before we submit.
Yes. CAQH re-attestation every 120 days, Medicare revalidation every five years and commercial re-credentialing, usually every three years, go on a calendar we watch, so nothing lapses.
Yes. We don’t list our clients on this site, but ask us and we’ll arrange it: with a current client’s permission, we share their contact details so you can hear how we work from them directly.
From our guides
Get credentialed with insurance
Every step from NPI to a loaded contract, in the order that saves weeks, with what goes wrong at each one and how to keep it from happening to your file.
How long does credentialing take?
Credentialing times by payer, the rules that set your effective date, and a 120-day plan that keeps a new provider from seeing patients you cannot bill for.
Specialties we credential
Adding a provider or a new payer?
Let’s get it moving. Send us your provider list and we’ll audit your active payer enrollments and revalidation dates, free.