Credentialing for Solo Physician Practices
Opening a solo practice is one of the most rewarding decisions a physician can make. It is also one of the most administratively intensive. Credentialing and payer enrollment can take 3 to 6 months per payer, and managing 10 or 15 payer applications simultaneously while also building a practice is simply not sustainable.
We handle the complete enrollment process for solo practitioners from the moment they decide to open their practice through their first billing cycle and beyond. We establish CAQH profiles, submit to all target payers in parallel, follow up proactively, and deliver a comprehensive enrollment summary when approvals come in. Our average solo practice client is billing all target payers within 90 to 120 days of engagement.
Credentialing for Group Medical Practices
Group practices face the full complexity of solo credentialing, multiplied by the number of providers, plus the added layer of group-level TIN enrollment, reassignment of benefits, and coordination across multiple provider files simultaneously. When a group adds providers, acquires a practice, or expands to new states, every one of those changes requires credentialing work across every payer.
We serve as the outsourced credentialing department for group practices ranging from 2 providers to 50 or more. Our project management system tracks every provider file independently, with coordinated scheduling to optimize sequencing and ensure no provider waits unnecessarily. We also manage group-level enrollment, TIN changes, location additions, and any payer notifications required when the group structure changes.
Credentialing for Telehealth Platforms
Telehealth providers face a uniquely complex credentialing landscape. Seeing patients in multiple states requires licensure in each state, separate payer enrollment in each state where the provider practices virtually, and knowledge of state-specific telehealth parity laws that affect coverage and reimbursement.
We specialize in multi-state telehealth credentialing and understand the FSMB Interstate Medical Licensure Compact, the Nurse Licensure Compact, and the state-by-state variation in what telehealth services payers must cover. We credential telehealth providers efficiently across all required states, prioritizing the states with the largest patient populations and the best commercial payer coverage for virtual care.
Credentialing for Behavioral Health Providers
Behavioral health credentialing is among the most challenging in healthcare. Panel closures are common at major commercial payers. Reimbursement rates are highly variable. Supervision requirements for associate-level clinicians add complexity. And the documentation requirements for LCSWs, LPCs, psychologists, and psychiatrists differ significantly by payer and state.
Our behavioral health credentialing specialists understand these nuances in depth. We know which payers have closed panels and how to approach panel reopening requests effectively. We understand supervision and collaboration documentation requirements for associate-level clinicians. And we know how to structure applications for behavioral health providers to maximize approval rates and minimize back-and-forth with payer credentialing committees.
Credentialing for Hospitals and Health Systems
Hospital and health system credentialing operates on a different scale and requires coordination between medical staff credentialing for privileges and payer enrollment for billing. New physicians joining a health system often need privileges at multiple facilities and enrollment with dozens of payers simultaneously, all within a defined onboarding timeline.
We partner with health system credentialing departments to manage the payer enrollment component of provider onboarding, freeing the medical staff office to focus on privilege application processing and committee approvals. Our team integrates with existing credentialing software systems and reporting workflows to provide seamless coordination between facility credentialing and payer enrollment for every new provider.
Credentialing for Medical Billing Companies
Medical billing companies often have clients whose credentialing needs are beyond what the billing team can manage efficiently. Credentialing delays create billing backlogs. Lapsed revalidations create claim denials. And the resources required to manage credentialing well are significant enough that many billing companies prefer to refer this work to a specialist.
We work as a white-label credentialing partner for medical billing companies nationwide. We handle the credentialing work under your client relationship, keeping your clients enrolled and billing while you focus on coding, claims, and collections. Our billing company partners get dedicated account support, integrated status reporting, and pricing structured to support profitable resale of credentialing services.
Do not see your organization type listed?
We work with a wide range of healthcare organizations beyond those listed here. Contact us to discuss your specific credentialing needs and we will tell you exactly how we can help.