Credentialing & Provider Enrollment Services for Healthcare Physicians
Provider credentialing and payer enrollment don't have to slow down your revenue. Our team handles the entire process from application to approval, ensuring accuracy, compliance, and faster turnaround so your practice can start billing without delays.
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Complete Provider Enrollment &
Credentialing Services
We handle every step of the enrollment and credentialing process so you don't have to.
Insurance Enrollment Services Across
Major Payers
We handle enrollment and credentialing with Medicare, Medicaid, and all major commercial insurance providers. Our relationships with credentialing departments across these payers accelerate activations and reduce delays.
Provider Enrollment & Credentialing
Timelines
Enrollment timelines vary by payer and application completeness. Here are the typical timelines you can expect with clean, complete applications:
Medicare Provider Enrollment
60-90 days average from CMS-855 submission to PECOS activation. Clean applications are processed faster.
Commercial Insurance Credentialing
90-120 days for initial credentialing with commercial payers, depending on payer processing speed and CAQH profile completeness.
Medicaid Enrollment
State-specific timelines vary. We manage enrollment across all 50 states with state-specific requirements and processing timelines.
CAQH Re-Attestation
Re-attestations occur every 120 days. Updates typically take 5-20 minutes and are approved within days. We manage the entire cycle so providers never miss deadlines.
Healthcare Credentialing Professional
Certifications
Our credentialing specialists hold industry recognized certifications that demonstrate expertise in provider enrollment and credentialing.
NAMSS Certification Standard: CPCS and CPMSM certifications from the National Association of Medical Staff Services (NAMSS) are the industry gold standard for credentialing professionals. Our team maintains active certifications and participates in ongoing education to stay current with Medicare, Medicaid, and commercial payer enrollment requirements.
What We Guarantee (And What We Don't)
We're transparent about what we control and what we don't. Here's what you can expect from RevaxisMD:
We Guarantee
- Clean, complete submissions with zero documentation gaps
- CAQH accuracy and proactive re-attestation management
- On-time filing of credentialing applications before deadlines
- Proactive follow-ups and escalation when delays occur
- Transparent weekly status reporting on every application
- Audit-ready documentation and compliance records
- Coordinated billing support once providers are activated
We Do Not Guarantee
- Payer review speed or committee approval timing (controlled by payers, not us)
- Network openings (determined by payer network expansion decisions)
- Medicare MAC processing backlogs (CMS-determined, outside our control)
- State board verification timelines (state-controlled process)
- Specific enrollment completion dates (timelines vary by payer)
Compliance & Risk Management in
Provider Enrollment
Enrollment errors create compliance exposure and revenue risk. We maintain strict standards for HIPAA compliance, accurate provider representation, CMS policy adherence, and secure documentation storage.
HIPAA Compliant Data
Handling
Accurate Provider
Representation
CMS & Payer Policy
Compliance
Audit-Ready
Documentation
Who Benefits Most From Provider
Enrollment & Credentialing Services
Our services are ideal for practices and healthcare organizations that fit these descriptions:
New Practices Launching Operations
You're opening doors and need providers enrolled with all payers immediately. We align credentialing timelines with your practice launch to minimize activation gaps.
Growing Groups Adding Providers or Locations
You're expanding and can't afford enrollment delays. We accelerate credentialing so new providers can bill as soon as they start seeing patients.
Practices Switching Billing Vendors
Your current vendor doesn't track enrollment. We audit your current enrollment status, identify gaps, and fix enrollment issues that are blocking payments.
Providers Facing Enrollment Delays or Denials
You're stuck waiting for payer activation. We escalate delays, appeal denials, and use payer relationships to accelerate approval.
Clinics With Payer Activation Issues
You have providers who are supposed to be enrolled but claims are still getting denied. We track down enrollment gaps and fix them.
Organizations Managing Multi-Location Enrollment
You have multiple locations with different payer networks and credentialing requirements. We manage the complexity across all locations and payers.
Frequently Asked Questions About
Provider Credentialing Services
Provider enrollment is the process of registering a healthcare provider with a payer (Medicare, Medicaid, commercial insurance) to establish a billing relationship. Credentialing is the verification of a provider's qualifications, licenses, certifications, and credentials. Both are required before a provider can bill through a payer. Enrollment without proper credentialing leads to denials. Credentialing without enrollment means the provider isn't in the payer's system at all. We handle both simultaneously.
Medicare enrollment typically takes between 60 to 90 days from the time of CMS-855 submission to PECOS activation, provided there are no documentation errors or delays in background verification.
Delays are often caused by incomplete CAQH profiles, missing documentation, slow response from payer credentialing committees, or backlogs within commercial insurance departments.
If an application is denied, we identify the exact reason for the denial, gather any additional required documentation, and submit a formal appeal or re-application to secure approval.
Revalidation is the process where payers periodically re-verify provider credentials (typically every 3 to 5 years for Medicare) to ensure ongoing compliance and active licensure.