Credentialing & Provider Enrollment
Stay enrolled and in-network with organized credentialing handled start to finish.
How AccMed RCM Handles Credentialing & Provider Enrollment
A provider who is not properly credentialed and enrolled cannot get paid in-network, no matter how clean the claims are. AccMed RCM manages credentialing and payer enrollment end to end: applications are prepared accurately, submitted to each payer, tracked through approval, and kept current so participation never lapses without warning.
We maintain the details that practices lose track of, including CAQH profiles, license and certification renewals, revalidation dates, and re-credentialing cycles. Whether you are enrolling a new provider, adding a location, joining a new payer panel, or keeping an established group current, the paperwork is handled and the deadlines are watched.
What Our Credentialing & Provider Enrollment Cover
Payer enrollment applications
Enrollment applications for commercial payers, Medicare, and Medicaid are prepared and submitted accurately.
CAQH profile management
CAQH profiles are created, completed, attested, and kept current so payer applications move without delays.
Medicare and Medicaid enrollment
PECOS and state Medicaid enrollments and revalidations are handled, including group and individual applications.
Re-credentialing tracking
Re-credentialing and revalidation dates are tracked per provider and payer, with work started before deadlines approach.
Document collection and verification
Licenses, DEA, malpractice, and education documents are gathered and checked so applications are complete the first time.
Application status follow-up
Submitted applications are followed up with payers until approval and effective dates are confirmed.
New provider and location enrollment
New hires, new locations, and practice changes are enrolled with your existing payers without gaps in participation.
Why Practices Choose This Service
No participation gaps
Enrollment and re-credentialing deadlines are tracked centrally, so in-network status does not lapse by accident.
Faster approvals
Complete, accurate applications avoid the back-and-forth that delays payer approval for months.
Claims pay from day one
New providers are enrolled before they start seeing patients, so their claims are payable in-network immediately.
One less administrative burden
Forms, follow-up calls, and document chasing are handled for you, across every payer.
Clear status at all times
You can see where every provider’s enrollment stands with every payer, without digging through paperwork.
Insurance Credentialing, Start to Finish
Credentialing and enrollment decide whether a payer will pay you at all. We manage the full lifecycle for every provider: initial applications, contracting, CAQH upkeep, revalidations and recredentialing — so no payer stops paying because a date was missed.
- Medicare — PECOS enrollment, reassignment to your group and revalidation.
- Medicaid — state Medicaid and managed care plan enrollment.
- Commercial payers — applications, contract requests and in-network status.
- CAQH ProView — profile setup, document uploads and regular re-attestation.
- NPI and practice data — NPPES updates, addresses and taxonomy codes.
- Ongoing monitoring — license, DEA, malpractice and revalidation dates tracked.
Who We Credential
NPs, PAs and therapists
Enrollment for advanced practice and behavioral health providers.
Learn more →How This Fits Your Revenue Cycle
Every service we offer connects to one complete billing workflow, so nothing falls between the cracks:
Insurance Eligibility & Verification
We confirm coverage and benefits before a claim is ever created.
Charge Entry & Medical Coding
Charges are captured and coded accurately with CPT and ICD-10.
Claim Scrubbing & Submission
Every claim is checked for errors, then submitted electronically.
Payment Posting
Payer payments and adjustments are posted accurately from remittance data.
Denial Management & Appeals
Denials are reviewed, corrected, and appealed where appropriate.
A/R Follow-Up
Unpaid claims are tracked and followed up until resolved.
Patient Billing
Patient statements and balances handled with clear, simple workflows.
Reporting & Analytics
Regular reports on claims, payments, denials, and A/R aging.
Credentialing & Provider Enrollment for Every Specialty
Our workflows adapt to your specialty’s coding rules and payer requirements. See the full list on our specialties page.
Credentialing & Provider Enrollment Questions, Answered
How long does credentialing take?
Timelines are set by the payers and commonly run from several weeks to a few months depending on the payer and application type. We submit complete applications promptly and follow up consistently, which is the part of the timeline within your control.
Do you handle Medicare enrollment?
Yes. We manage Medicare enrollment and revalidation through PECOS for individuals and groups, as well as state Medicaid enrollment, alongside commercial payer credentialing.
We are hiring a new provider. When should credentialing start?
As early as possible, ideally as soon as the hire is confirmed. Starting before the provider’s first day is what allows claims to be billed in-network from the start instead of held or written off during a long enrollment gap.
Can you take over credentialing we started ourselves?
Yes. We review applications already in progress, confirm their status with each payer, correct anything incomplete, and take over tracking and follow-up from that point.
What is the difference between credentialing and enrollment?
Credentialing is the payer’s review of a provider’s qualifications — license, education, training and history. Enrollment (or contracting) is getting that provider set up to bill and be paid by the payer, often linked to a group. Both must be complete before claims are paid in-network.
How often does recredentialing happen?
Most payers recredential providers about every three years, and Medicare requires revalidation on a regular cycle. CAQH profiles need re-attestation every 120 days. We track all of these dates.
Can you credential providers in multiple states?
Yes. We enroll providers with payers in every state where they are licensed and see patients, including telehealth providers.
Our Other Services
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