How It Works

To begin the credentialing process, we'll need: a copy of your medical license(s), DEA certificate, medical school diploma, residency/fellowship completion certificates, current CV, malpractice insurance certificate (with claims history if available), board certification documents, NPI number, and CAQH ID (or we'll help you set one up). Don't worry—we'll send you a complete checklist after your free consultation.

We provide a dedicated credentialing portal where you can track real-time status updates on all your applications. You'll receive email notifications whenever there's a status change, and you can reach your assigned credentialing specialist directly. We also conduct proactive weekly follow-ups with payer representatives to identify and resolve any issues before they become delays.

While denials are uncommon when applications are properly prepared, they do happen. If an application is rejected, we immediately investigate the reason, correct any issues, and resubmit. We don't consider our job done until you're fully credentialed. Most rejections can be resolved within 2-4 weeks with proper follow-up.

Absolutely! Initial credentialing is only the beginning. Most payers require recredentialing every 2-3 years. We proactively monitor expiration dates and begin the recredentialing process 90-120 days before deadlines to ensure there are no gaps in your billing ability. We also handle all mid-cycle updates like address changes, new tax IDs, or adding locations.

Credentialing is the verification process—proving you are who you say you are and meet all the payer's standards. Contracting is the legal agreement that establishes your rates and terms for reimbursement. You must be credentialed before you can contract. We handle both processes: first getting you credentialed, then negotiating and executing the contracts on your behalf.

Yes, but you'll need to be upfront with patients about your status. Many practices see patients as self-pay during the credentialing period, then retroactively bill insurance once enrolled (if the payer allows retroactivity). Some payers also allow "provisional" or "pending" status that enables limited billing. We'll advise you on the best approach for each specific payer.