Credentialing is not paperwork you do once. It is a calendar you keep. We run the applications, confirm the effective dates, and track the revalidation deadlines that quietly turn paid claims into write-offs.
We treat credentialing as an ongoing obligation with dates attached, not a one-time submission. That is the difference between a provider who bills in network on day one and one who racks up 90 days of unbillable claims.
We pull every provider, payer and effective date you already have, and find the gaps, lapses and revalidation dates nobody is tracking.
Licences, DEA, malpractice, board certification, work history and W-9s collected once, verified, and kept in one place so no application stalls on a missing document.
CAQH built and attested, PECOS for Medicare, state Medicaid portals, and commercial panel applications filed per payer with the right group and tax ID linkage.
Weekly follow-up on every pending application, effective dates confirmed in writing, and revalidation and re-credentialing dates calendared before they bite.
Plan for 90 to 150 days per payer. Medicare via PECOS often moves fastest, commercial panels are slower, and Medicaid varies widely by state. The clock only starts when the application is complete, so missing documents are the single biggest cause of delay.
Usually no. Most commercial payers will not pay claims with a date of service before the provider's effective date. Medicare allows retrospective billing up to 30 days in most cases. The safe approach is to hold those claims rather than submit and appeal, and to track the effective date per payer.
CAQH ProView is the shared credentialing database most commercial payers pull from. It requires re-attestation every 120 days. If attestation lapses, payers can stop pulling your data mid-application, which silently stalls credentialing and can affect existing contracts.
Credentialing verifies the provider's licence, education, training, work history and malpractice record. Enrollment links that verified provider to a specific payer contract and tax ID so claims actually pay. A provider can be credentialed and still not be enrolled under the right group.
Medicare can deactivate the billing privilege, which stops payment until it is reinstated, and reinstatement is not always retroactive. Commercial payers may move the provider out of network, which turns in-network claims into patient balances. Revalidation dates are the deadlines worth tracking hardest.
Free Behavioral Health Billing X-Ray. No setup fees, no long-term contract.
