Credentialing & Insurance Paneling
Getting credentialed is the #1 bottleneck for new practices. We take it completely off your plate—from application to approval.
The Credentialing Challenge
You finished residency. You're ready to see patients. But before you can bill insurance, you need to be credentialed with every payer—a process that typically takes 90-180 days and involves mountains of paperwork.
Each payer has different requirements, different forms, and different timelines. CAQH needs to be perfect. Medicare has its own enrollment system (PECOS). Commercial payers each have their own portals and processes.
This is where we come in. We handle the entire credentialing process so you can focus on building your practice—not fighting with insurance company hold queues.
What We Handle
CAQH ProView
We create your CAQH profile from scratch, upload all required documents, and keep it updated. Most payers require an active CAQH profile to even begin the credentialing process.
Medicare & Medicaid
PECOS enrollment for Medicare, state-specific Medicaid applications, and ongoing revalidation. Government payers are essential for most practices.
Commercial Payers
Aetna, BCBS, United, Cigna, Humana, and regional payers. We identify which networks are most important for your location and specialty.
Primary Source Verification
We verify your credentials directly with issuing sources: medical schools, residency programs, state boards, DEA, and certifying bodies.
Application Tracking
We follow up with payers weekly, respond to additional requests, and keep you updated on status. No more wondering where your application stands.
Hospital Privileging
If you need hospital affiliations, we prepare privileging applications and coordinate with medical staff offices.
Powered by Credentialed™
Most credentialing services are entirely manual—staff calling state boards, waiting on hold, and manually checking databases. We built software to automate the verification process.
Our Credentialed platform performs real-time primary source verification, checking NPI registries, OIG exclusion lists, and state medical boards automatically. This means faster turnaround and continuous compliance monitoring.
Typical Timeline
While we can't control payer processing times, we minimize delays by getting applications right the first time.
Document Collection & Verification
We gather your credentials, set up your CAQH profile, and begin primary source verification. You'll receive a checklist of documents needed.
Application Submission
Applications submitted to Medicare (PECOS), Medicaid, and commercial payers. Each payer has different portals and requirements.
Payer Review & Follow-up
We track application status, respond to payer requests for additional information, and follow up regularly to prevent delays.
Approvals & Contract Execution
Approvals start coming in. Medicare is typically fastest (30-45 days), commercial payers take 60-90 days. We help you execute contracts and set up billing.
* Timelines vary by payer and state. Some payers are closed to new providers or have waiting lists.
Ready to Get Credentialed?
Let's discuss your situation and create a credentialing plan tailored to your specialty and location.