Do you provide insurance credentialing and provider enrollment services?

Yes, we offer full-service credentialing and enrollment for individual providers, groups, and facilities. Our services include initial credentialing, re-credentialing, CAQH profile management, primary source verification, application submission to all major payers, and ongoing monitoring of credentialing status and expiration dates.

Can you help me become an in-network provider?

Absolutely. We manage the entire in-network enrollment process including payer research, application preparation, contract negotiation support, status tracking, and follow-up until approval. Our established relationships with payers and knowledge of current requirements expedite the process and improve approval rates.

Do you handle Medicare, Medicaid, and commercial payer credentialing?

Yes, we credential providers with Medicare (PECOS enrollment), Medicaid (state-specific applications), and all major commercial payers including United Healthcare, Aetna, Cigna, Blue Cross Blue Shield, Humana, and regional plans. We also handle facility credentialing for hospitals, ASCs, and diagnostic centers.

Can you credential providers for telehealth practices?

Yes, we specialize in telehealth credentialing including multi-state licensure tracking, telehealth-specific payer enrollments, and compliance with state-specific telehealth regulations. We ensure your providers are properly credentialed for virtual care delivery across all states where you practice.

Do you offer group and individual provider credentialing?

We handle both individual practitioner credentialing and group practice enrollments. For groups, we manage organizational credentialing (NPI Type 2), location additions, and ensuring all providers are properly rostered under the group tax ID for accurate reimbursement.

Can you help with re-credentialing and CAQH updates?

Yes, we provide ongoing re-credentialing management and proactive CAQH maintenance. We monitor expiration dates, update profiles quarterly or as needed, attest applications, and ensure continuous network participation without coverage gaps. Our alert system ensures no credentialing deadlines are missed.

Do you assist with payer contracting and fee schedule negotiation?

Yes, we support payer contract negotiations including fee schedule analysis, reimbursement rate comparison, contract language review, and negotiation strategy development. While we don't serve as legal counsel, our 20+ years of experience helps you understand market rates and leverage better contract terms.

How long does the credentialing process take?

Credentialing timelines vary by payer: commercial payers typically take 60-120 days, Medicare 30-60 days, and Medicaid 60-90 days. Factors affecting timeline include application completeness, payer backlog, and specialty requirements. We provide regular status updates and expedite when possible through direct payer contacts.

Can you submit claims while credentialing is still pending?

In most cases, claims should be held until credentialing is complete to avoid denials. However, we can assist with retroactive billing strategies, participating provider agreements that allow backdating, and locum tenens arrangements. We'll develop the best approach based on your specific payer contracts and situation.

Do you support specialty credentialing (mental health, ABA, WC, labs)?

Yes, we handle specialty-specific credentialing including behavioral health panels, ABA provider networks, workers' compensation carrier enrollments, laboratory CLIA certification support, and specialty-specific requirements like board certifications, DEA registrations, and specialty-specific liability insurance documentation.