Provider Credentialing & Payer Contracting
Accelerate Payer Enrollment & Prevent Costly Out-of-Network Billing Delays
Every month a new provider waits for commercial insurance or Medicare/Medicaid enrollment costs your practice an estimated $60,000 to $90,000 in unbillable revenue. Provider Billers speeds up enrollment and re-credentialing through relentless payer follow-up.
45-60 Days Saved
100% Up to Date
99.8%
Common Practice Bottlenecks Solved
New physician hires unable to bill insurance for 4 to 6 months due to stalled enrollment paperwork
Lapsed CAQH profiles or missed re-credentialing deadlines triggering sudden out-of-network status
Commercial payer panels closed to new providers without strategic appeal justification
Practices accepting unfavorable fee schedules without benchmarked rate negotiations
Key Deliverables & Standard Operating Procedures
Our 4-Step Operational Workflow
Document Collection
We gather your CV, diplomas, state licenses, DEA, CDS, malpractice face sheets, and board certificates.
CAQH & Payer Application
Complete preparation and electronic submission to Medicare, Medicaid, and targeted commercial carriers.
Relentless Payer Pestering
Bi-weekly phone check-ins with credentialing committees to prevent applications from sitting in administrative limbo.
Effective Date & Contract Execution
Securing countersigned provider agreements, effective billing dates, and linking NPIs to clinic billing tax IDs.
Frequently Asked Questions
How long does medical credentialing typically take in the US?
Commercial payers typically take 90 to 120 days, while Medicare takes 45 to 60 days via PECOS. Our proactive follow-up eliminates administrative stalling, shortening overall turnaround times significantly.
Can we bill retroactively for services rendered while waiting for credentialing?
Medicare allows up to 30 days of retrospective billing from the date the application was submitted. Some commercial payers honor backdating if negotiated upfront. We guide you on the exact rules for your state and payer mix.
Ready to Upgrade Your Practice’s Credentialing?
Take the risk-free first step with our Free 10-Claim Denial Audit. We pinpoint the exact leaks in your current billing workflow within 48 business hours.
(209) 671-6993
Request Your Free 10-Claim Audit for Credentialing
Zero upfront cost. We sign a HIPAA BAA before examining any documentation.