Provider Credentialing & Enrollment

A single credentialing delay can cost a provider thousands per week in unbilled revenue. We manage enrollment, revalidation, and CAQH maintenance end to end so your providers stay in-network and billable.

We handle the full lifecycle — initial payer enrollment, CAQH profile setup and quarterly attestation, NPI and PECOS management, and managed-care contracting support — and track every application and revalidation date in one system instead of a spreadsheet or a sticky note. Because we follow up with payers directly rather than waiting on their timeline, applications move through the queue faster than when enrollment is squeezed in alongside everything else on a practice’s plate.

The costliest credentialing mistake is treating it as a one-time task instead of an ongoing one — CAQH attestations lapse, licenses expire, and a provider quietly drops out-of-network with a payer nobody was watching. We build a forward calendar of every date that matters per provider, so a revalidation gets started weeks before the deadline instead of being discovered after a claim denies for network status.

This service fits any practice bringing on a new provider, expanding into a new payer network, or realizing mid-year that no one has been tracking revalidation dates — which, in our experience, describes most practices at some point, regardless of size.

A telltale sign you need this: a provider’s claims start denying for not-in-network even though they’ve been seeing patients at your practice for months. That almost always means an enrollment or revalidation slipped through, and it’s far more expensive to fix after the fact than to have prevented.

Your providers keep practicing; behind the scenes, we’re the ones tracking CAQH attestation windows, submitting applications, and following up with payers so a credentialing gap never becomes a billing gap. Most practices only notice this service is working because nothing goes wrong.

Credentialing is the gate everything else passes through — a provider who isn’t properly enrolled can’t be billed correctly no matter how good your medical billing process is. We treat it as the foundation the rest of the revenue cycle depends on.

Our standard is zero silent lapses — every date that matters for every provider is tracked in one system, and we’d rather flag a revalidation six weeks early than explain a denied claim after the fact.