Medicare, Medicaid and commercial plans
Payer Enrollment Services for New Providers and Practices
Medtransic enrolls new providers and practices with Medicare, Medicaid and commercial insurance plans, including the CAQH profile and Medicare's PECOS. Enrollment is $150 per application, per provider, and in our experience usually takes 60 to 90 days with each payer. We follow up on each one until you have an effective date.
| Payer | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Commercial A | · | · | · | · | · | · | ✓ | · | · | · | ||
| Commercial B | · | · | · | · | ? | · | · | · | · | ✓ | · | |
| Medicare | · | · | · | · | · | · | · | · | · | ✓ | ||
| Medicaid | · | · | · | · | · | · | ? | · | · | · | · | |
| Advantage plan | · | · | · | · | · | · | · | · | · | · |
Weeks across the top. Two of these five are still open at week twelve, and a clinician cannot bill a payer until their row ends in a tick.
Our Proven Enrollment Process
Six steps, from planning to your first billable claim.
- Assessment & Planning
- We review your practice information, specialties, locations, and target payer mix to create a customized enrollment strategy.
- Document Collection
- We gather all required documents including licenses, certifications, malpractice insurance, DEA, and provider attestations.
- Application Preparation
- Our specialists complete every enrollment application carefully, following each payer's specific requirements.
- Submission & Tracking
- We submit applications through appropriate channels (CAQH, PECOS, direct payer portals) and track every file to its effective date.
- Follow-Up & Resolution
- Proactive follow-up with payers to expedite processing and resolve any issues or requests for additional information.
- Confirmation & Setup
- We confirm effective dates, obtain payer IDs, and make sure your billing system is updated before claims go out.
What We Deliver in Payer Enrollment, Explained
From initial applications to ongoing revalidation, we manage every aspect of your payer enrollment lifecycle.
Initial Payer Enrollment
Complete enrollment with Medicare, Medicaid, and commercial insurance plans including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna, and Humana.
- CAQH profile setup and maintenance
- Medicare PECOS enrollment
- Medicaid state-specific applications
- Commercial payer applications
- Participating provider agreements
Re-Enrollment & Revalidation
Timely re-enrollment and revalidation services to maintain your in-network status.
- Medicare revalidation every 5 years
- Medicaid re-enrollment tracking
- CAQH attestation (every 120 days)
- Payer roster updates
- Proactive deadline monitoring
Multi-Location & Group Practice
Specialized enrollment services for practices with multiple locations and providers.
- Group NPI enrollment
- Multi-state licensure coordination
- Facility credentialing
- Practice location additions
- Provider roster management
Enrollment Status Tracking
Regular status reports on every application, and each application's status by payer in the client portal.
- Application status by payer
- Proactive payer follow-up
- Issue resolution and appeals
- Effective date confirmation
- Credentialing database updates
Persistent Bottlenecks in Payer Enrollment
Without proper payer enrollment, you cannot bill insurance companies or receive reimbursements. Our enrollment services ensure you're in-network and ready to accept patients quickly.
- Faster Enrollment
- Every application followed up on a set schedule, so files do not sit.
- Complete Applications
- Clean, complete application submissions with proactive follow-up until each payer approves.
- Bill Sooner
- Start billing sooner and widen your patient base by being in-network with the plans your patients carry.
- Compliance-Focused
- Stay compliant with all federal and state requirements, plus individual payer policies.
- Dedicated Support
- A dedicated account manager, plus the specialists who work your applications.
- Complete Documentation
- We handle all paperwork, credentialing databases (CAQH, PECOS), and follow-up.
What We Deliver in Payer Enrollment, Explained
From initial applications to ongoing revalidation, we manage every aspect of your payer enrollment lifecycle.
Initial Payer Enrollment
Complete enrollment with Medicare, Medicaid, and commercial insurance plans including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna, and Humana.
CAQH profile setup and maintenance / Medicare PECOS enrollment / Medicaid state-specific applications / Commercial payer applications / Participating provider agreements
Re-Enrollment & Revalidation
Timely re-enrollment and revalidation services to maintain your in-network status.
Medicare revalidation every 5 years / Medicaid re-enrollment tracking / CAQH attestation (every 120 days) / Payer roster updates / Proactive deadline monitoring
Multi-Location & Group Practice
Specialized enrollment services for practices with multiple locations and providers.
Group NPI enrollment / Multi-state licensure coordination / Facility credentialing / Practice location additions / Provider roster management
Enrollment Status Tracking
Regular status reports on every application, and each application's status by payer in the client portal.
Application status by payer / Proactive payer follow-up / Issue resolution and appeals / Effective date confirmation / Credentialing database updates
Payers We Work With
We handle enrollment with all major government and commercial insurance payers across the United States.
Government Payers
- Medicare
- Medicare Advantage Plans
- State Medicaid programs
Major Commercial Payers
- Blue Cross Blue Shield (All Plans)
- UnitedHealthcare / Optum
- Aetna / CVS Health
- Cigna
- Humana
- Anthem
Regional & Specialty Payers
- Regional HMOs and PPOs
- Medicaid managed care plans
- Behavioral health organizations
Common Enrollment Challenges We Solve
Payer enrollment is complex and time-consuming. Let our experts handle these common challenges:
Long Processing Times
Credentialing usually takes 60 to 90 days with each payer, in our experience, when every file is followed up.
Complex Documentation
Each payer has unique requirements. We track exactly what each payer needs so applications go in complete.
Missing Deadlines
Revalidation and attestation deadlines can result in termination. We track all deadlines proactively.
Application Denials
Errors and incomplete applications cause delays. We verify every application before submission to reduce this frustration.
Multi-State Complications
Each state has different requirements. We coordinate enrollment across every state you serve.
Ready to Get Enrolled?
Start accepting more patients and get paid by the plans they carry.
- $150 per application, per provider
- Dedicated account manager
- Application status by payer in the client portal
Related Services
Credentialing Services
Provider credentialing that pairs with payer enrollment.
Learn moreMedical Billing Services
Start billing as soon as enrollment is complete.
Learn morePractice Launch Support
Enrollment and setup for new practices from day one.
Learn morePayer Enrollment Services Guide
How enrollment timelines affect when you can bill.
Learn moreStrengthen Your Payer Enrollment Results
Credentialing usually takes 60 to 90 days with each payer, in our experience. We work every file until it has an effective date.