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Provider Enrollment & Credentialing

Our Provider Enrollment & Credentialing services help healthcare providers manage enrollment, credentialing, recredentialing, payer participation, and ongoing provider information requirements.

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Services Included

Provider Enrollment & Credentialing

  • Provider Enrollment with Health Insurance Plans

  • Provider Credentialing & Recredentialing

  • Initial Provider Credentialing

  • Provider Recredentialing

  • Group & Individual Provider Enrollment

  • Rendering Provider Enrollment

  • Billing Provider Enrollment

  • Organizational / Group Enrollment

CAQH, NPI & Provider Information

  • CAQH Profile Management

  • CAQH Provider Data Verification

  • NPI Application & Maintenance

  • NPPES Updates & Maintenance

  • Provider Demographic Updates

  • Address & Practice Location Updates

  • Taxonomy Updates

  • Specialty Updates

  • Tax ID / TIN Updates

  • W-9 Documentation

Payer Contracting & Network Participation

  • Payer Contracting & Participation

  • Provider Network Participation

  • Provider-to-Group Linking

  • Provider Roster Management

  • Payer Roster Updates

  • Payer Directory Updates

  • Provider Directory Accuracy Review

Provider Documentation & Verification

  • License & Certification Verification

  • Professional License Tracking

  • DEA & Controlled Substance Registration Verification

  • Board Certification Verification

  • Malpractice Insurance Verification

  • Education & Training Verification

  • Work History Verification

  • Hospital Privileges Verification

  • Disclosure & Attestation Management

  • CAQH Attestation

Applications, Follow-Up & Issue Resolution

  • Provider Application Preparation

  • Payer Enrollment Application Submission

  • Enrollment Status Follow-Up

  • Payer Correspondence & Follow-Up

  • Enrollment Issue Resolution

  • Payer Enrollment Rejections & Corrections

  • Effective Date Verification

  • Contract Effective Date Tracking

  • Provider Participation Status Verification

Medicare, Medicaid & Health Plan Enrollment

  • Medicare Enrollment

  • Medicaid Enrollment

  • Medi-Cal Enrollment

  • Commercial / Private Insurance Enrollment

  • HMO & PPO Network Enrollment

  • Government Health Plan Enrollment

  • Medicare Revalidation

  • Medicaid / Medi-Cal Revalidation

  • Medicare PECOS Enrollment

  • Medicaid State-Specific Enrollment

  • Managed Care Organization Enrollment

  • IPA / Medical Group Enrollment

  • Behavioral Health Network Enrollment

  • Telehealth Network Enrollment

Provider Changes, Rosters & Disenrollment

  • Change of Ownership / Practice Information Updates

  • Provider Termination & Disenrollment

  • Provider Additions & Removals from Rosters

Financial & Electronic Enrollment Support

  • EFT Enrollment & Updates

  • ERA Enrollment & Updates

  • Clearinghouse Enrollment Support

Credentialing Compliance & Reporting

  • Credentialing Compliance & Monitoring

  • Credentialing Documentation Management

  • Credentialing Expiration Tracking

  • Provider Enrollment Reporting

Comprehensive Enrollment & Credentialing Services

  • All-Inclusive Provider Enrollment & Credentialing Services

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