Credentialing — In-Network in 60 Days, Not 6 Months
Credentialing delays cost months in lost revenue. We complete CAQH, primary source verification, and payer applications in 60-90 days — PECOS, NPPES included.
Proven Results
- 75 Average Days to Credential
- 100% Application Accuracy
- Zero Credentialing Lapses
- 250+ Payers We Work With
Us vs. Typical Billing Company: Credentialing
| Category | Medtransic | Typical Billing Company |
|---|---|---|
| Time to Credential | 60-90 days average | 120-180 days average |
| Application Accuracy | 100% complete, first-time acceptance | 60-70% require resubmission due to errors |
| Re-Credentialing | Automated 120-day advance tracking, zero lapses | Manual calendar reminders, frequent lapses |
| CAQH Management | Full profile setup, quarterly attestation, proactive updates | Initial setup only, provider self-manages |
| Payer Coverage | 250+ payers, parallel multi-payer processing | Limited to major commercial payers, sequential processing |
| Status Visibility | Real-time status dashboard with milestone tracking | Periodic email updates upon request |
Common Challenges
Lengthy Application Process
Credentialing applications with insurance payers take 90-180 days, delaying practice revenue and preventing providers from seeing patients.
Complex Documentation Requirements
Each payer requires unique forms, supporting documents, and verification methods creating administrative complexity and errors.
Re-Credentialing Lapses
Missed re-credentialing deadlines cause provider enrollment to lapse, halting all claim payments until re-enrollment is complete.
CAQH Profile Maintenance
Keeping CAQH profiles current with licenses, certifications, and practice information requires constant monitoring and updates.
Multiple Payer Requirements
Each insurance company has different credentialing requirements, creating a maze of paperwork and follow-up for practices.
Privileging & Hospital Credentialing
Hospital medical staff credentialing and privileging add another layer of complexity with separate requirements and timelines.
Our Solutions
Expedited Credentialing Process
Expert credentialing specialists who know payer requirements ensure complete, accurate applications submitted quickly the first time.
- Average 60-90 day credentialing timeline
- Complete application accuracy prevents delays
- Direct payer relationships expedite processing
- Parallel processing of multiple payers
CAQH Profile Management
Comprehensive CAQH profile setup and ongoing maintenance keeps provider information current and accessible to all payers.
- Initial CAQH profile creation and optimization
- Quarterly profile attestation and updates
- License and certification monitoring
- Proactive document upload and management
Re-Credentialing Tracking
Automated tracking system monitors all re-credentialing deadlines and initiates renewal process well in advance to prevent lapses.
- Deadline tracking prevents enrollment lapses
- 120-day advance renewal initiation
- Zero interruption in payment eligibility
- Complete audit trail of all renewals
Comprehensive Enrollment Support
End-to-end support for all credentialing needs including commercial payers, Medicare, Medicaid, and hospital medical staff.
- All commercial payer credentialing
- Medicare and Medicaid enrollment
- Hospital medical staff credentialing
- Specialty-specific payer networks
Service Features
Initial Credentialing
Complete credentialing application preparation and submission for new providers joining your practice.
- Application completion
- Document gathering
- Primary source verification
- Payer submission and follow-up
CAQH Profile Setup
Comprehensive CAQH database profile creation and ongoing maintenance for streamlined payer access.
- Profile creation
- Document upload
- Quarterly attestation
- Update management
Re-Credentialing Services
Proactive monitoring and management of all re-credentialing requirements to prevent any lapses.
- Deadline tracking
- Renewal initiation
- Updated documentation
- Continuous enrollment
Network Expansion
Strategic enrollment with additional payer networks to expand patient access and revenue opportunities.
- Network analysis
- Contract negotiation support
- Multi-payer coordination
- Specialty networks
Our Process
Document Collection & CAQH Setup
We gather all required provider documents — medical license, DEA, board certifications, malpractice insurance, NPI — and create or update your CAQH ProView profile.
Payer Application Submission
Credentialing applications are submitted to each target payer including Medicare (PECOS), Medicaid, and commercial plans. Each payer's specific requirements and forms are handled.
Application Tracking & Follow-Up
We monitor each application through the payer's credentialing committee, respond to information requests, and escalate delays. Average turnaround is 60–90 days per payer.
Contract Review & Enrollment
Once approved, we review your provider participation agreement, verify contracted rates, and confirm your effective date for claims submission.
Ongoing Re-Credentialing Management
We proactively track all re-credentialing deadlines and CAQH attestation dates to prevent any lapses in your payer enrollment status.
Related Billing Resources
Key Services
- provider credentialing
- medical credentialing
- payer enrollment
- provider enrollment
- credentialing services
Contact Medtransic today for expert credentialing services. Call 888-777-0860 or visit https://medtransic.com/contact for a free consultation.