Accelerate your path to in-network status with comprehensive provider credentialing services. Our certified credentialing specialists handle the complete enrollment process from initial application through final approval, reducing credentialing time from 120 days to 45-60 days while achieving a 98% approval rate for premium payer networks.
Medical credentialing requires meticulous attention to detail, where a single error can delay approvals for months. Our dedicated credentialing team verifies every license, certification, and credential at the source, ensuring error-free applications that move through payer review processes efficiently.
Stop leaving revenue on the table while waiting for credentialing approvals. Let our expert enrollment specialists navigate complex payer requirements, manage primary source verification, maintain CAQH profiles, and secure maximum privileges for your practice.
Achieve preferred provider status with premium reimbursement rates that maximize revenue for every service rendered, increasing profitability by 15-25% compared to out-of-network rates.
Secure full admitting privileges, surgical rights, and participation in value-based care programs with quality incentives that reward clinical excellence and patient outcomes.
Begin submitting claims on day one with proper provider identification numbers, electronic claim submission capabilities, and real-time eligibility verification, eliminating revenue delays.
Experience consistent cash flow with average reimbursement processing in 15-30 days compared to 45-90 day cycles for out-of-network providers ensuring financial stability.
Benefit from established relationships with insurance companies where our credentialing team negotiates on your behalf, resolves issues proactively, and ensures fair payment terms.
Eliminate claim denials caused by credentialing issues through comprehensive eligibility verification, authorization management, and accurate credential validation before submission.
We specialize in securing coveted in-network contracts even with highly selective payer panels. Whether you're a solo practitioner or an expanding group, we navigate the technical complexities to ensure your seat at the table.
Book a demoOur expedited provider credentialing services streamline the journey from initial application to final approval through a systematic, efficient process. Providers submit their information once, and we handle the rest—from primary source verification to submitting pristine application packets.
Minor errors create major delays—an incorrect date or missing document can pause credentialing for months. We prevent delays by identifying issues early and maintaining documentation trails that payers accept without additional questions.
Our Systematic Approach to Provider Enrollment Success
Credentialing specialists conduct in-depth interviews gathering license numbers, DEA registrations, board certifications, and work history.
We verify credentials at primary sources (state boards, education programs) ensuring accuracy before submission.
Assessment of practice goals and patient demographics to maximize reimbursement opportunities.
Evaluation of payer networks considering rates, volume, contract terms, and specialty alignment.
Real-time confirmation of panel openings to avoid wasted effort on closed networks.
Complete profile creation serving as a centralized repository for all payer verification requests.
Direct verification with medical schools, residency programs, and board certification entities.
Weekly status checks and proactive responses to prevent any application stalls.
Direct communication with payer representatives to bypass standard queues and resolve issues immediately.
Real-time status updates provided to you showing anticipated completion dates and current stages.
Analysis of fee schedules and terms negotiation to secure higher reimbursement rates when possible.
Coordination of effective dates and EDI enrollment for seamless billing operations.
Concurrent processing of hospital applications to prevent post-credentialing delays.
Management of committee reviews and final privilege granting confirmation.
Proactive monitoring of licenses, DEA, and board certifications with 90-day advance reminders.
Ongoing monitoring of changing payer requirements and regulatory modifications.
Comprehensive Enrollment Services for All Provider Types
Complete PECOS enrollment including CMS-855I (individual), 855B (institutional), 855A (institutional), and 855S (DMEPOS) applications.
Enrollment in all 50 state programs with expertise in state-specific documentation and managed care requirements.
Military health system (DEERS) and Children's Health Insurance Program enrollment to expand patient access.
Credentialing with UnitedHealthcare, Anthem, Aetna, Cigna, Humana, BCBS, Kaiser, and Highmark plans.
Participation in HMO, PPO, EPO models and Medicare Advantage organizations with distinct application processes.
Type 1 and Type 2 NPI application and management; EIN/SSN coordination aligned with business structure.
Tracking of state medical licenses and DEA registrations for prescribe authority across multiple locations.
ProView development with EDUCATION, certifications, and insurance declarations ensuring complete readiness.
Mandatory quarterly attestations and real-time updates for practice modifications or new certifications.
Coordination through ACHC, HQAA, or Joint Commission and assistance securing CMS-standard surety bonds.
Strategic selection of HCPCS product categories ensuring authorization for all equipment types.
Simultaneous processing of medical staff applications, privilege delineation, and committee presentation support.
Fee schedule analysis against Medicare benchmarks and negotiation of favorable terms/hold-harmless clauses.
Proactive renewal management 90+ days before deadlines and specialized handling of Medicare revalidation.
Ongoing monitoring of changing payer requirements and standards affecting provider eligibility.
Root cause analysis of credentialing denials and recovery of underpaid amounts from out-of-network status.
Coordination of claim submission for services provided during retroactive effective date periods.
With over 15 years of expertise, we serve healthcare practices across all 50 states, managing state-specific requirements and payer nuances.
Credentialing Expertise Across All Professional Designations
Enrollment with National & Government Insurance Networks
Flexible Solutions for Every Practice Need
Core Enrollment Services for startups and small practices.
Comprehensive Credentialing & Ongoing Management.
Complete Practice & Revenue Cycle Management.
No-obligation consultation • Expert payer network analysis
Healthcare Billing Services is a full-service medical billing company, managing everything from coding and claims to payment and follow-up. Our expertise ensures accurate, efficient billing for practices of any size or specialty, so you can focus entirely on patient care.