Services / Credentialing
Physician credentialing & payer enrollment services
Provider enrollment and insurance credentialing handled accurately and tracked to approval, so new providers can see — and bill for — patients sooner.
How we do it
A new physician who is not yet enrolled with your payers is a physician you cannot bill for. Credentialing delays can cost a practice months of a provider’s revenue, and a single missed revalidation can stop payments from Medicare or a commercial plan without warning. Our credentialing service takes that risk off your administrator’s desk.
We manage the full enrollment cycle: CAQH profile setup and attestation, Medicare PECOS and Florida Medicaid enrollment, commercial payer applications, hospital and ASC privileging paperwork, and group-to-individual linking so claims pay under the right NPI. Every application is tracked to its effective date, and we follow up with the payer rather than waiting for a letter that may never come.
After the initial enrollment we keep the file current. License, DEA and board certification expirations are monitored, re-credentialing and revalidation deadlines are calendared, and changes in practice location or group affiliation are filed before they cause a denial. Because we also do your billing, we know the moment a credentialing gap starts to affect payments.
What’s included
Everything credentialing should cover.
- Provider enrollment with commercial and government payers
- CAQH setup and maintenance
- Re-credentialing and revalidation tracking
- Expiration and license monitoring
Common questions
Credentialing questions, answered.
- How long does physician credentialing take in Florida?
- Commercial payers generally take 60 to 120 days from a complete application; Medicare enrollment through PECOS is often faster, and Florida Medicaid and the managed Medicaid plans vary. The biggest delays come from incomplete applications and unanswered payer requests, which is exactly what we manage. Start the process as soon as a provider signs, not when they arrive.
- Can you credential a provider who is joining an existing group?
- Yes. We enroll the individual provider with each payer and link them to your group’s existing contracts and tax ID, so their claims pay at the group’s negotiated rates from the effective date. We also handle the reverse when a provider leaves, so your group is not billed for someone no longer practicing under it.
- Do you handle re-credentialing and revalidation?
- Yes. We track every re-credentialing cycle (typically every two to three years for commercial payers and every five years for Medicare revalidation) along with license, DEA, malpractice and board certification expirations, and file renewals ahead of the deadline so there is no gap in payments.