Medical Credentialing and Payer Enrollment
Get on the panels, stay on the panels, and stop losing revenue to lapsed enrollments.
Credentialing is slow, administrative and unforgiving. A missed revalidation date can drop a provider from a panel without warning, and the first sign is usually a batch of denials weeks later.
We handle the applications, the follow-up calls, the CAQH attestations and the calendar of revalidation dates. The work itself is not complicated. Doing it consistently, for every provider and every payer, is what practices struggle with.
The problem
Where this usually goes wrong
Revenue lost during the gap
A new provider who is not credentialed cannot bill. Every week of delay is a week of billable work that either goes uncollected or gets billed under someone else, which is its own problem.
Silent lapses
Revalidation dates arrive without warning. A provider drops off a panel, claims start denying as out of network, and by the time anyone traces it back you have weeks of rework.
Nobody chases the payer
Applications sit. Payers lose paperwork. Without someone calling every two weeks, a 90-day process becomes a 180-day process.
What is included
- New provider enrollment with commercial and government payers
- Medicare PECOS enrollment and revalidation
- Medicaid enrollment, including state-specific requirements
- CAQH profile setup, maintenance and quarterly attestation
- Commercial panel applications and contract follow-up
- Group and facility enrollment, including new location adds
- Revalidation calendar with advance reminders before every deadline
- NPI registration and demographic updates
- Ongoing payer roster reconciliation
How it runs
Our process
- 1
Document collection
One intake per provider: licenses, DEA, malpractice, board certifications, work history, references. We chase the gaps so your office manager does not have to.
- 2
CAQH and primary source setup
Profile built or cleaned up, attestation current, primary source verification items in place. Most payer applications pull from here, so errors propagate if this is wrong.
- 3
Application submission
Applications filed with each target payer, tracked individually with a submission date and reference number rather than sent and forgotten.
- 4
Follow-up cycle
Every application called on a fixed schedule until an effective date is issued. This is the step that determines whether it takes 90 days or 180.
- 5
Maintenance
Revalidation dates loaded into a calendar with reminders ahead of each deadline, CAQH re-attested quarterly, and roster checks against each payer.
Questions we get asked
How long does credentialing take?
Commercial payers typically run 60 to 120 days from a complete application. Medicare is usually 45 to 90 days. The variable is not the payer, it is how fast complete documentation is assembled and how consistently the application is followed up.
Can we bill for a provider while credentialing is pending?
It depends on the payer and whether retroactive effective dates are available. Some payers backdate to the application date, some do not. We tell you which of yours do before you plan around it.
Do you handle Medicare revalidation?
Yes, including PECOS revalidation and the reminder calendar so it does not lapse. Missed revalidation is one of the most common and most avoidable causes of sudden denials.
What if a payer panel is closed?
We submit anyway with a case for network need, and we track the panel for reopening. Closed does not always mean closed, especially for specialties with thin coverage in a region.
Is credentialing available without billing services?
Yes. Plenty of practices keep billing in house and outsource only credentialing, because it is the piece that is easiest to let slip.
What do you need from us to start?
A signed BAA, a list of providers and target payers, and access to existing CAQH profiles. We send a single document checklist per provider and handle the rest.
Related services
See what your practice is leaving on the table.
We look at 90 days of your claims data and tell you what is recoverable. No cost, no obligation, BAA signed before anything changes hands.
- Recoverable dollars in your aged A/R, as a number
- Denials grouped by root cause, ranked by value
- A written summary you keep either way
Prefer to talk? (301) 786-0552
Or email info@asesormd.com