Credentialing Consultants
Our Credentialing Services
- Medicare Enrollment for organizations and individual providers
- Tricare Military Enrollment
- Commercial insurance provider enrollment
- Medicaid enrollment for organizations and individual providers
- Bi-Weekly or Monthly Status Reports on completions
- Application tracking and follow up
- Insurance appeals for closed panels
- Rejection and denial assistance
- Reapplication assistance if needed
Additional Services
- PECOS Registration
- CAQH
- NPPES
- Availability Registration, Update & Management
These services are needed prior to start of credentialling. They are available for an additional cost. Please see our fee section.
Credentialing Applications Timeline
Providers with no state board license to practice will require 6-9 months to complete since no applications can be sent until all licenses have been filed and received.
Physicians who are already certified in the state will require 3-6 months to credential. This time frame begins when all completed applications and licenses have been received by our credentialing department.
Note: If the provider is already par under a different tax ID, new state law mandates that the payers streamline the credentialing process.
- The Credentialing Contractor sends the application in the payer designated format to the payer and loads the information on CAQH and alerts the payer. If the provider does not participate with CAQH, they will initiate and complete the application process.
- The Credentialing department follows up on the status of outstanding applications regularly with all payers until the number is issued.
- The payer processes the application and loads the provider number in their system(s) under our tax ID. This can take 90-180 days after the completed application has been received.
- The payers send provider number and participation status correspondence directly to the provider. The provider/and or practice manager sends this correspondence to the Credentialing Department as soon as received.