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Accelerate Your Provider Enrollment and Get Approved Sooner
Applications filed within 48 hours with Medicare, Medicaid, BCBS, UHC, Aetna, Cigna, and all major payers
Get Credentialed Now
Provide your details below to receive a free multi-state payer enrollment assessment from our healthcare experts.
The Credexa Difference: Proactive Credentialing That Delivers Results
While most companies simply submit applications and wait, we take a different approach. We assign a dedicated owner to every file, conduct weekly payer follow-ups, and immediately escalate cases when a payer goes quiet to ensure your revenue cycle never stalls.
Streamlined Medical Credentialing
We accelerate your payer enrollment using rigorous audits, dedicated account managers, and weekly status tracking.
48-Hour Application Filing
We audit your NPI, CAQH, taxonomy, licensure, and malpractice dates before submission. This ensures a clean file that moves through the payer system without delays.
Dedicated Specialist
You work with one expert who owns your file from start to finish. There are no ticket queues, no handoffs, and no lost information.
50-State Enrollment
We handle Medicare, Medicaid, and commercial payer enrollment in every state. Our team navigates the unique requirements of every regional and national network.
Proactive Payer Contact
Contract Review
We review every contract before you sign to ensure the terms are favorable. Our team flags specific fee schedule terms that should be negotiated for better reimbursement.
Your providers can't bill until the payer says yes
Every week a provider sits unapproved is a week of lost revenue for your practice. We eliminate the wait by managing the entire process with relentless follow-up.
- Filed in 48 hours
- Fee schedules reviewed
- Weekly payer follow-up
- Recredentialing tracked
Provider enrollment and credentialing services, from NPI setup to revalidation
Credentialing Status
- NPI Registry Setup
- CAQH Profile Attestation
- Payer Enrollment & Contracting
- Medicare Revalidation
Comprehensive Administrative Services
Navigate complex healthcare networks with ease. Our experts streamline your credentialing, compliance, and revenue setups to optimize efficiency.
Get Your Credentialing Assessment
Find the gaps before a payer does.
Our 6-Step Credentialing Process
Credentialing readiness audit
Payer selection and network mapping
Our team identifies the most strategic insurance networks for your practice and maps out a targeted enrollment plan.
Profile setup and application submission
We handle the heavy lifting of CAQH profile updates and the meticulous submission of all payer-specific enrollment applications.
Weekly follow-up and escalation
We don’t just submit and wait; we perform weekly status checks and escalate delays to ensure your applications stay on track.
Contracting and payment setup
Once approved, we assist in reviewing contracts and ensuring your electronic funds transfer (EFT) and billing info are correctly linked.
Recredentialing and revalidation calendar
We provide a proactive management system to track upcoming recredentialing dates, preventing any lapses in your network status.
How long payer credentialing takes
There is no single universal timeframe for credentialing because every payer operates on its own internal review cycle. Individual file processing varies significantly based on state regulations, provider specialty, and the completeness of the initial application.
Payer Turnaround Timelines
MEDICARE
AETNA
CIGNA
UNITEDHEALTHCARE
TRICARE
BLUE CROSS BLUE SHIELD
MEDICAID
Varies widely by state
* Estimates based on typical files; timing varies. Standard processing windows can fluctuate based on seasonal claims volumes, medical necessity reviews, and document quality.
Why Timelines Stall vs. How We Protect Them
What pushes a file past the window
Several factors can stall an application, often restarting the clock entirely.
- Taxonomy mismatch with PECOS records.
- CAQH attestation lapsed past the 120-day window.
- Malpractice coverage expiring during the review period.
- Address mismatch between application and IRS records.
A single rejection often forces a complete restart of the payer review process.
What weekly follow-up actually does
Proactive tracking ensures your file doesn’t sit idle in a payer’s queue.
- Identifying requests sent to unchecked provider portals.
- Catching rejections before they are mailed out.
- Ensuring files are actually assigned to a reviewer.
- Flagging files that have stalled past the standard window.
Our goal is to catch and resolve issues in week three instead of discovering them in week twelve.
When expedited credentialing is actually possible
What changes when you enroll with Medicaid, Medicare, or a commercial payer
These three distinct payer types bring three different sets of challenges to the enrollment process.
Medicaid: fifty programs, not one
Every state runs its own
Medicaid is not a single entity but 50 separate programs. Each state requires its own unique application, often followed by additional enrollment steps for every managed care plan (MCO) within that state.
Rules change without a notice period
State requirements shift frequently. We manage this by maintaining parallel multi-state filing systems to ensure compliance even when rules change mid-process.
Take the Stress Out of Medicaid Credentialing
Medicare: the form decides everything
Picking the wrong action type
Medicare enrollment is driven by PECOS. Whether it is CMS-855I for individuals, 855B for groups, or 855R for reassignment, selecting the wrong form or action type results in an immediate rejection and a complete restart.
Revalidation and MAC jurisdiction
Providers must revalidate every five years. Because notices are sent to the address on file in PECOS, missing a notice can lead to deactivation. We ensure your filings go to the correct Medicare Administrative Contractor (MAC) every time.
Get Expert Support for Medicare Credentialing
Insurance credentialing with commercial payers
Closed panels
Some commercial networks are closed to new providers regardless of how perfect your paperwork is. We help you navigate these barriers.
What we do when a panel is closed
- Target alternative open plans to maintain revenue.
- File appeals based on documented network need or specialty gaps.
- Set a schedule to revisit and reapply when panels reopen.
Getting the rate right
Credentialing isn’t just about being in-network; it’s about the contract. We review the fee schedule with you before you sign to ensure the rates are sustainable.
One Step Closer to Private Payer Payments
Outsourcing provider enrollment and credentialing without losing control
Payer Enrollment: In-House vs. Outsourced
Compare how managing credentials internally stacks up against partnering with dedicated specialists.
Doing it in-house
Managing enrollment using existing administrative staff.
01. What it costs
The cost is hidden within existing salaries but often results in overtime or neglected core tasks.
02. Staff time
Requires significant hours for manual follow-ups, portal logins, and document gathering.
03. Where it breaks
Breaks when staff turnover occurs or when the primary coordinator is overwhelmed by other duties.
04. When it works
Works for very small practices with a single provider and a low volume of payer changes.
Outsourcing it
01. What it costs
A predictable flat fee of $299 per enrollment, allowing for clear budget forecasting.
02. Staff time
Minimizes staff involvement to initial document handoff and final signature.
03. Where it breaks
Only breaks if communication channels between the practice and the partner are not maintained.
04. When it works
Works for growing practices, multi-state groups, and any clinic where revenue depends on fast enrollment.
Enrolling multiple providers or multiple states at once
As your practice grows, the complexity of enrollment multiplies exponentially with every new provider, payer, and state line. Managing this manually often leads to overlapping deadlines and missed revalidations.
We utilize parallel filing and a single-view status roster to track every provider simultaneously. We monitor effective dates across the entire group to ensure no one begins billing before their approval is finalized.
The comparison that usually decides it
What payers ask for during credentialing and enrollment
Stalled applications usually stem from paperwork that doesn’t line up. Ensuring these documents are ready before submission is the fastest way to approval.
Provider Details
- Full name
- Date of birth
- Home and mailing address
- Contact number
- SSN
- Citizenship or work authorization
- Current CV
- Education and training
- Medical school and residency documentation
- Board certification
- Specialty certifications
- State licensing
- DEA registration where applicable
- NPI
- CAQH ProView ID and attestation date
- Work history including gaps
- Peer references
- Malpractice claims history
- Disciplinary actions
- Languages spoken
Practice Details
- Practice name and address
- Tax ID
- Contact number
- Primary contact
- Hospital affiliations
- Medical group affiliation
- Professional liability certificate
- Certificate of insurance
- Accepting new patients
- Patient age range treated
Missing a single document after submission can cost weeks because most payers will restart the entire review process.
Provider enrollment and credentialing packages
Every package includes application submission, weekly follow-up until approval, and CAQH management.
Simple, Scalable Rates for Credentialing
No hidden fees. Select the plan that matches your practice size and start onboarding your providers smoothly.
Solo provider
For individual providers.
- Payer application submission & tracking
- CAQH setup & maintenance
- Weekly status updates
- Participation & effective date confirmation
- EFT & ERA enrollment
Group practice
For multiple providers under one or more tax IDs.
- Individual & group enrollment
- CAQH for every rendering provider
- Recredentialing tracking
- Centralized status reporting
- Fee schedule review
- Dedicated credentialing manager
Multi-state telehealth
For providers operating across multiple states.
- Parallel multi-state enrollment
- State-specific handling & rules
- CAQH alignment & updates
- Medicaid enrollment by state
- Participation confirmation per state
What Leading Healthcare Providers Say
“Collecting verified patient reviews has never been this seamless. Our Google rating went from 4.1 to 4.8 in just three months, significantly boosting new patient volume.”
Dr. Sarah Jenkins, MD
Pediatrician, Jenkins Medical Group
“The automated verification process ensures all our client reviews are authentic and audit-ready. It has saved our compliance team dozens of hours of manual tracking.”
Marcus Vance
Clinic Director, Vanguard Orthopedics
“Patients frequently mention how simple it is to leave reviews now. The administrative backend is incredibly intuitive and integrates smoothly with our practice flow.”
Dr. Amit Patel, DDS
Owner, Apex Dental Care
Trusted by healthcare providers nationwide
Provider enrollment and credentialing services questions practices ask most
Navigating the complexities of payer enrollment can be overwhelming. We have compiled the most frequent questions to help you understand the process and how we support your practice.
