Credentialing & Enrollment Services Simplified, Accurate, Compliant
At RevenueCycle Pros we streamline the provider credentialing and payer enrollment process so you can focus on delivering patient care. Our services ensure that your providers are verified, enrolled, and contracted with insurance payers faster and with fewer delays—ensuring timely reimbursement and regulatory compliance.
What is Credentialing and Enrollment?
Credentialing is the process of verifying a provider’s education, training, licenses, certifications, and professional experience to ensure they meet payer and industry standards.
Enrollment involves registering a provider with insurance payers (commercial, Medicare, Medicaid) so they can receive reimbursements for services rendered.
Both processes are essential for:
- Becoming in-network with insurance companies
- Ensuring regulatory and payer compliance
- Reducing delays in payment
- Maintaining a trustworthy reputation in the healthcare industry
Why Credentialing & Enrollment Matters
Failing to properly credential or enroll providers can lead to
- Claim denials or delayed payments
- Legal and compliance risks
- Patient dissatisfaction and administrative headaches
That’s why outsourcing your credentialing to experts ensures faster processing, cleaner documentation, and full compliance with state and federal regulations.
Our Credentialing & Enrollment Process
Our step-by-step, transparent approach makes credentialing and enrollment efficient and worry-free
Document Collection
We begin by gathering all required documents from the provider, including
Licensure, DEA certificate, NPI
Board certifications, malpractice insurance         Â
CV, work history, and references
We audit the documents to ensure completeness and accuracy
CAQH Profile Management
We create or update the provider’s CAQH ProView profile, ensuring all fields are accurate and attested. We monitor it for re-attestation deadlines to maintain active status.
Primary Source Verification
Our team conducts verification through:
- State medical boards
- DEA/NPI databases
- Education and residency programs
This ensures full compliance with NCQA, CMS, and payer-specific guidelines.
Payer Enrollment Applications
We prepare and submit enrollment forms for:
- Medicare
- Medicaid
- Commercial payers (Aetna, BCBS, Cigna, etc.)
- Worker’s comp and specialty networks
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We track all submissions and provide real-time status updates.
Follow-Up and Payer Communication
Our credentialing specialists maintain continuous communication with payers:
- Respond to additional information requests
- Resolve application errors or discrepancies
- Escalate delayed enrollments
Contracting & Effective Date Confirmation
Once enrollment is approved, we ensure:
- Contracts are reviewed and signed
- Reimbursement rates are confirmed
- Effective dates are tracked to avoid revenue gaps
Ongoing Maintenance & Re-Credentialing
We track re-credentialing timelines (typically every 2–3 years), license renewals, and re-attestations to ensure your credentials remain active and valid.
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Who We Serve
We offer credentialing and enrollment services for
Physicians & Group Practices
Nurse Practitioners (NPs) & Physician Assistants (PAs)
Mental Health Providers
Ambulatory Surgery Centers (ASCs)
Urgent Care Centers
Telehealth Providers
Therapists
DME Suppliers
Facilities and Labs
Home Health
SNF
Dentists
Benefits of Partnering with RevenueCycle Pros
- Faster payer enrollment & reduced turnaround time
- Error-free documentation and submission
- Full transparency with real-time tracking
- HIPAA-compliant data handling
- Dedicated credentialing specialists
- Affordable pricing with no long-term contracts
Call Us
Get Credentialed Faster - Get Paid Sooner
Start your journey with a credentialing partner that understands your needs. Contact RevenueCycle Pros today for a free consultation or to request a credentialing checklist tailored to your specialty.