Affordable physician credentialing services
Insurance Credentialing
Service for Physicians
- Insurance Credentialing for Medicare and Medicaid Enrollments
- CAQH Registration and Attestations
- Commercial Insurance Credentialing
- Contract Negotiations
- Demographic updates
- Re-Credentialing Services
- EFT Setups
- Hospital Admitting Privileges
- IPA Enrollments
- Directory Verifications
zero
upfront fee
Medical Credentialing Services
starting from
$ 140
PER application
First Time Approval
Revenue Increase
Denial Reduction
Client Satisfaction
Affordable
insurance credentialing services
Get Credentialed with as many insurances companies as you want
NPI registration & Maintenance
CAQH Registration & Maintenance
Medicare , Medicaid & Telehealth Credentialing
Credentialing & Re-Credentialing with PPOs and HMOs.
credentialing services for providers
99% Approval Rate
Contracting & Negotiations.
Direct deposit setups.
Demographic Updates.
Quarterly Directory Verification.
Insurance Credentialing Service for Physicians
Whats involved
Clinics
&
House calls
Private practices
&
Telehealth Startups
Surgery centers
&
Hospital Privileges
IPA Affiliations
&
Hospitals credentialing
Physician Credentialing Services
Services We Offer
Initial Provider Enrollment & Credentialing
Handles the initial application process for physicians to join insurance networks (e.g., Medicare, Medicaid, and commercial payers like Aetna or UnitedHealthcare). Includes gathering documents (licenses, CVs, malpractice insurance) and submitting applications to ensure eligibility for reimbursement.
Primary Source Verification (PSV)
Verifies the authenticity of a physician’s credentials (e.g., education, training, licenses, board certifications) by contacting original sources like medical schools and state boards. Critical for compliance and reducing fraud risks
CAQH Registration & Maintenance
Creates and updates profiles on the Council for Affordable Quality Healthcare (CAQH) ProView system, streamlining credentialing with multiple payers. Includes regular attestations to keep data current.
Medicare & Medicaid Enrollment
Manages enrollment with government programs, including PECOS (Medicare’s Provider Enrollment System) and state Medicaid portals. Ensures compliance with CMS requirements and retroactive billing eligibility.
Commercial Payer Credentialing
Facilitates contracts with private insurers (e.g., Blue Cross Blue Shield, Cigna). Negotiates favorable reimbursement terms and resolves delays in network participation.
Revalidation & Recredentialing
Updates credentials every 3–5 years (per payer requirements) to maintain active status. Includes demographic updates and reverification of licenses/DEA certifications.
NPI Registration (Type 1 & Type 2)
Secures National Provider Identifiers (NPIs) for individual providers (Type 1) and group practices (Type 2), essential for HIPAA-compliant billing.
Contract Negotiation
Advocates for higher reimbursement rates and favorable contract terms with payers, leveraging industry benchmarks
DEA & State License Managemen
Assists with Drug Enforcement Administration (DEA) certifications and state medical license renewals, including CLIA lab registrations.
Insurance credentialing for Providers
Credentialing Process
Benefits of Outsourcing
Medical Credentialing Services
Faster Enrollment
Reduce credentialing time from 90-120 days to just 30-45 days with expert handling
Higher Revenue
Start billing sooner with accelerated network participation
Compliance Assurance
Ensure adherence to CMS, NCQA, and payer requirements
Reduced Denials
Minimize claim rejections with error-free credentialing
CAQH Optimization
Professional maintenance of your CAQH profile
Document Management
Centralized tracking of licenses and certifications
Staff Productivity
Free your team to focus on patient care
Timely Recredentialing
Never miss renewal deadlines
Payer Negotiation
Leverage data for better reimbursement rates
FAQ
Ask us anything
The standard time frame for physician credentialing application process is 30-120 business days, Some insurances even take more than 120 days and some process applications within 45 days.
Your dedicated account manager will help you evaluate the right payers according to your specialty and location. We help you negotiate contracts in the best possible way. Transparent and timely client communication is the main focus of our medical credentialing service. We send biweekly application status updates.
In general and on average, expect to pay $250-$399 per provider per payer for physician credentialing services.
No, you will have to wait until your medical provider credentialing and contracting application gets approved.
To complete the medical provider credentialing process, you should have the following documents.
- State License
- Malpractice insurance
- DEA certificate
- Resume
- Board certificate
- IRS letter (EIN letter)
- Business Voided Check
- General Liability insurance
- Educational and Professional history of medical provider
- Article of Incorporation in case of business
Physician.
Provider Name, NPI, Specialty, SSN, Date of Birth, Birth Country & State, Contact Number, Home Address, CAQH Username & Password, NPPES Username & Password, Office Hours
Practice.
Practice Name, Tax ID, Practice NPI, Practice Specialty, Service Location, Mailing Address, Practice Phone Number, Practice Fax Number
Owner.
Percentage, Name, Date of Birth, SSN, Home Address, Cell Number, NPPES Username & Password, Birth Country & State
Yes & No.
It depends on your specialty, patient volume, and state you are practicing in, but it is always recommended to complete your Medicare provider enrollment process before applying for other insurances.
It depends on multiple factors such as your specialty, the state you are practicing in, and the insurances you are applying for.
We can help you get your individual or business NPI within 24 hours for FREE.
Yes, you will either get an approval letter via mail or an email from the medical insurance payer on approval of your physician credentialing application.
All Major
Specialties covered
Primary Care
Family Medicine
Internal Medicine
Pediatrics
OB/GYN
General Surgery
Orthopedic Surgery
Cardiology
Dermatology
Endocrinology
Gastroenterology
Neurology
Oncology
Pulmonology
Radiology
Emergency Medicine
Psychiatry
Anesthesiology
Urology
Ophthalmology
Otolaryngology (ENT)
Physical Medicine & Rehab
Geriatrics
Allergy & Immunology
Insurances Covered
Insurance Credentialing Service
Trusted by providers nationwide.
Verified Credentialing Results
We strive to maximize your revenue & reduce expenses with our expertise to get your credentialing done in the minimum possible time.
Get your concerns resolved in real time. Talk to your dedicated manager whenever you want.
Locations
Serving Nationwide
Enjoy faster credentialing services across the nation! We are now available in all 50 states. So, wherever your practice might be, don’t hesitate to contact our expert team to unburden your administrative staff.Â
Experience team
Lead by Expert
Adam has helped hundreds of healthcare providers start, grow, and sustain medical practices by providing 100% customer-focused, quick-response, and affordable solutions. Get in touch to discuss more.
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Rx Credentialing is offering medical billing, Insurance credentialing, medical licensure, Insurance eligibility verification and Virtual healthcare assistance services to medical practices across all 50 states.
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