CAQH preparation and maintenance
Build or update the provider profile, check supporting documents and track required re-attestation. Confirm the provider’s review and authorization rather than assuming a saved profile is complete.
Credentialing
Keep provider enrollment from becoming a blind spot.
Credentialing and payer enrollment support for solo providers and groups. We organize profiles, applications, supporting documents, follow ups and renewal dates so your practice can see what is complete and what is still pending.
Submitted does not mean ready to bill.
An incomplete CAQH profile, an unmatched tax record or an unlinked rendering provider can hold up an application and later affect billing. A submitted application needs a documented status and a next action, not just a confirmation email.
WHAT IS INCLUDED
A defined scope.
Connected responsibilities.
Agree on the work before it begins.
Add services when your practice needs them.
Commercial payer applications
Prepare the payer specific application, record submission references and follow up on outstanding requests. Track the provider, group and location separately where the payer requires it.
Medicare and Medicaid enrollment
Coordinate PECOS and relevant state application requirements within the agreed scope. Resolve missing information with the practice; eligibility and enrollment decisions remain with the program.
Individual and group details
Check Type 1 and Type 2 NPI information, taxonomy, practice address and tax identification consistency. Track group associations and requested locations so billing has a reliable enrollment record.
Participation and fee schedule visibility
Organize participation documents and available fee schedules for the practice to review before signing. Flag open questions and effective dates; legal advice and final contract decisions remain with the practice and its advisers.
Renewals and changes
Maintain a calendar for recredentialing, licenses, insurance documents and practice changes. An address change or added provider should trigger a check of affected payer records.
WHAT YOUR PRACTICE RECEIVES
Work you can see
and questions you can act on.
- An application tracker by provider, payer and location
- A list of outstanding documents and practice actions
- Submission references, follow up notes and payer responses
- Effective dates, participation records and renewal reminders
HOW THE WORK MOVES
From a complete record to a documented decision.
Build one consistent record
Compare provider details across NPI, CAQH, licenses, insurance and business records. Identify gaps before applications are prepared.
Submit and follow up
Prepare the agreed payer applications and track each response. Review open applications weekly and record payer contact attempts, requested corrections and the next follow up.
Confirm the handoff to billing
Record the payer decision, effective date and any remaining EFT, ERA or portal steps. An application approval alone does not establish that every billing connection is ready.
PRICING AND EXPECTATIONS
Know what drives your quote.
Charged per payer. Provider count and application volume affect the quote, with discounted quotations for 10 or more payers. Follow up responsibilities are defined in the agreement.
BEFORE WE BEGIN
Details to clarify together.
No documents or practice information are required before a mutual contract is signed. Onboarding follows the agreement and, before PHI access, a BAA.
Timing varies by payer, specialty, application completeness and network availability. We report status and dependencies rather than promise an approval date.
No. Payers make participation and enrollment decisions. Closed panels, program requirements and contract terms can affect the outcome.
Requirements vary, but may include licenses, education, malpractice insurance, NPI and tax records. We provide a service specific checklist after the mutual agreement is signed.
CONNECT THE DETAILS
Start with your practice, not a generic proposal.
A Free Practice Review connects billing, credentialing, enrollment and payment setup. We agree on scope first, with a signed agreement and BAA before practice data moves.