A lapsed credential doesn't just inconvenience a provider — it creates a total billing blackout. Every claim submitted while a provider is un-credentialed is 100% unrecoverable. We prevent that from ever happening.
Credentialing is not a one-time event. It's an ongoing program of enrollment, maintenance, re-attestation, and renewal. We manage the full lifecycle so your team never has to touch a credentialing form.
Complete profile setup, quarterly attestation, and document management.
Medicare enrollment and re-validation to maintain CMS participation.
Commercial payer applications, follow-up, and fee schedule negotiations.
Automated alerts 90 days before any license, DEA, or board certification expires.
We handle every step from document collection through effective date confirmation and beyond.
We send each new provider a secure digital intake form to collect all required documents: DEA certificate, medical license, NPI, board certifications, malpractice insurance, work history, and references. Our team verifies the authenticity and currency of every document before proceeding.
We build or update the provider's CAQH ProView profile with complete, current information and ensure PECOS enrollment is active for Medicare participation. For new providers, we complete the full enrollment application with all supporting documentation attached.
Applications are submitted simultaneously to all target payers — commercial insurers, Medicaid MCOs, and specialty networks. We maintain a custom tracking spreadsheet per provider, updated daily, so you always know the exact status of every pending application.
We call each payer a minimum of twice per week to check application status. When applications stall, we escalate to provider relations departments and, where necessary, invoke expedited review provisions to compress the timeline.
Upon approval, we confirm effective dates in writing from each payer and load them into your billing system for immediate claims submission. We then assume ongoing management — scheduling re-attestations, tracking expiring documents, and monitoring for any payer-initiated re-credentialing requests.
Results vary by payer, but our proactive approach consistently compresses industry-standard timelines.
We combine certified expertise with proprietary technology to deliver unmatched revenue cycle performance.
Our advanced rules-based scrubbing engine runs every claim against millions of payer-specific rules before submission, practically eliminating front-end rejections and accelerating your cash flow.
We don't use generalists. Your account is managed by specialty-specific certified coders who understand the nuances of your exact clinical discipline, ensuring maximum compliant reimbursement.
Stop waiting for end-of-month reports. Our proprietary BI dashboards give you real-time visibility into collection rates, A/R aging, and denial trends.
We work seamlessly within your existing software via secure, HIPAA-compliant VPNs. Zero data migration required, and zero disruption to your clinical workflow.
Switching billing partners shouldn't disrupt your cash flow. Our meticulously engineered onboarding process ensures a smooth, parallel transition.
We establish secure remote access to your EHR/PMS and map your existing workflows without interrupting your current team.
We audit your past claims to identify immediate revenue leakage, coding errors, and systemic denial trends.
Our rules-based scrubbing engine is programmed with your specific payer matrix and local coverage determinations to prevent future denials.
We take over day-to-day operations, instantly applying our optimized workflows to accelerate your cash flow and reduce days in A/R.
Common questions about our process, integration, and security.
Let us audit your current credentialing status across all payers and identify any gaps or upcoming expirations before they become a billing crisis.
