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Healthcare Credentialing Services

We will assist Healthcare Providers and Healthcare Business Owners
of all specialties, in all states.

Smart Phone Outline
Medical Checkup

Our services include:

  • Private insurance provider enrollment 

  • Medicaid enrollment 

  • Medicare enrollment 

  • HRSA enrollment for uninsured COVID-19 testing

  • Application tracking and follow up

  • Rejection and denial assistance 

  • Reapplication assistance if needed

  • NPPES, CAQH, Availity and PECOS registration, update & management upon request 

Cost of Services

$199

For credentialing applications per insurance company, per provider, including private payers, Medicaid, Medicare

$279

One time fee for NPPES, CAQH, Availity, PECOS and other insurance clearinghouse registration, update & management upon request

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Credentialing Applications

Credentialing process takes up to 90-120 days or more

 

  • If you are credentialed with a payer through another company or employer, some payers will allow you to update your profile by changing or adding new  EIN's – This process is shorter and known as a demographic update. However this is not a guarantee for credentialing or for a faster process.

  • New Applications - Some payers take up to 120 days or more depending on the process that they have in place

Credentialing Process 

  • Obtain all necessary documents and information that are required for credentialing 

  • Verification is done if provider has been credentialed before – This determines if a full or a demographic application is need. 

  • Applications are initiated within 72 hours after all required documentation and information is received

  • 3-4 weeks after submission we will call and verify that applications have been received, after this we contact the insurances and payers every 4 weeks until for confirmation and status updates

  • Inform provider of updates on credentialing application status routinely

  • Assist with denial/rejections

  • Reapplication assistance as necessary

  • Credentialing renewal and recertification upon request 

Required Credentialing Documents 

Not all documents will apply to every practitioner/provider/professional

 

Required Documents for each Provider/Practitioner/Professional : 

 

  • Professional License(s) 

  • Malpractice Insurance (Certificate of Insurance) 

  • DEA Certificate  

  • Board Certification(s) 

  • NPI Numbers

  • Social Security Number

  • Diploma - copy of highest level of education (M.D., D.O, MSN, BSN etc)

  • Certificates of completion for all medical training (internship, residency, fellowship, courses, trainings) 

  • Current copy of CV (showing current employer and your business/practice and MM/YYYY on all education and experience) 

  • Completed IRS Form W-9 with signature

  • Current Driver's License 

  • Login and passwords for NPPES, CAQH, PECOS, HRSA and/or Availity (if applicable)

 

Required Documents for each Business Entity:

 

  • Business Registration/License from State (City/County Registrations if Applicable) 

  • IRS form CP575 or replacement letter 147C (verification of EIN) 

  • US Business Bank Letter and/or Voided Check

  • Signed W-9 Form 

  • CLIA Waiver Certificate (if performing laboratory tests in your clinic)

Credentialing Form
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