Provider Enrollments
Your Trusted Partner for Provider Enrollments
Our provider credentialing services ensure that providers meet all necessary requirements and standards for delivering care.
One-stop enrollment for Medicare, Medicaid, and private payers- Proactive follow-ups and timely updates on applications
- Submissions across 2,000+ insurance companies
- Rapid application turnaround and streamlined CAQH & PECOS setup
- Achieve approvals twice as fast
- Expert support on closed panel appeals
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Accelerate your credentialing and enrollment processes with real-time tracking and insights, accessible anywhere, anytime.
What we do
Network Research
We ensure that your practice or group has a diverse, popular, and effective mix of in-network payers. Our credentialing team is highly experienced in enrolling physicians with Medicare, Medicaid Managed Care plans, and all commercial payers. We contact each payer you want to enroll with to get accurate timelines and check if their panels are open..
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Application Filing
We provide you with a complete checklist of all the necessary information and documents needed to submit your applications. Once we receive the details from you, our Enrollment team files the required contract applications and ensures everything is submitted correctly the first time, thanks to our vast experience. Because of our accurate submissions, we take pride in having one of the fastest turnaround times for getting contracts approved.
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Application Follow-Up
Our team checks in on the submitted application every two weeks to make sure it has been received and is in the payer's system. We also ensure that no extra information is needed and that everything is going smoothly. We continue to follow up regularly until the contract is finalized and delivered to your location..
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Appeals for Closed Panels
Sometimes payers like UHC, Aetna, and BCBS have closed panels for labs in certain areas. When this happens, we send a detailed appeal highlighting the unique services you offer and how you provide exceptional patient care in your area. We include all these points in your business plan and submit it to senior provider representatives at the payer. While it's challenging to change closed panel decisions, we have a 30% success rate in doing so.
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Out of Network Enrollments
This service is for providers who choose not to join certain networks or are forced to stay out of network because of closed panels. Our team helps with out-of-network enrollments, including registering your NPI on the payer's website. This way, your medical practice is in the payer's system and can start receiving out-of-network payments.
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Demographic Changes
We assist with both basic and complex demographic changes, like updating a new Tax ID with all the payers in your network, changing your address, or updating your bank account. We also help set up all ERA and EFT enrollments.
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Annual Credentialing Maintenance
For larger healthcare facilities with multiple providers, managing an accurate provider database is crucial. We take care of all your providers' and physicians' credentialing data using our credentialing portal. This tool is comprehensive, transparent, and HIPAA compliant, designed to ensure your database is maintained with the highest efficiency and accuracy.
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PECOS AND CAQH SET UP AND MAINTENANCE
Keeping your PECOS and CAQH profiles up to date is essential in today’s healthcare world. Most major insurance companies now use CAQH to credential and enroll healthcare providers. We take care of setting up and maintaining your CAQH and PECOS profiles, ensuring your information is always accurate and compliant.
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Why Clients Trust Us
Years
12 Years of Provider / Hospital Credentialing and Enrollment experience
States
Extensive experience in all 50 states / State regulations / Rules and Compliance
Applications
Over 120,000+ applications successfully filed and contracts received
Customer Feedback That
Makes Us Proud
Don’t just take our word for it – see what our happy clients are saying about our
personalized medical billing services.
HomeCare Agency Owner
Our Customer
As a Homecare agency, navigating credentialing and enrollment can be a headache, but Credex Healthcare made it simple and straightforward. They took care of everything from our NPI management to PECOS enrollment, ensuring compliance at every step. Their expertise in primary source verification and network research helped us expand our network, allowing us to provide care to more patients. Highly recommend!
Pediatric Group
Our Customer
Credex Healthcare has been an invaluable partner for our multi-specialty group practice. They handled all our credentialing and enrollment needs, ensuring every provider was up-to-date across insurance networks and credentialing portals like CAQH and PECOS. Their ability to track and manage multiple providers’ licenses and certifications has saved us a tremendous amount of time and reduced our administrative burden.
Lab Director
Our Customer
Running a lab comes with its own set of compliance challenges, but Credex Healthcare has taken care of it all. They managed our CLIA waiver, credentialing, and enrollment processes, ensuring that we met every regulatory requirement. Their attention to detail and ability to handle complex credentialing issues has allowed us to focus on our operations without worrying about missing deadlines or facing compliance issues. Exceptional service!
HomeHealth Agency Owner
Our Customer
Credex Healthcare has been a game-changer for our HomeHealth agency. They managed our credentialing process from start to finish, ensuring all our licenses, DEA registrations, and CAQH profiles were up to date. Their expiration tracking system is incredibly helpful in keeping everything in check. Thanks to them, we can focus on delivering quality care to our patients without worrying about administrative hurdles.
Nurse Practitioner (NP)
Our Customer
Credex Healthcare has been amazing to work with. As a Nurse Practitioner, they took care of everything, from managing my NPI and PECOS enrollment to handling all my licensing and revalidation requirements. Their support has allowed me to concentrate fully on patient care, and their thorough primary source verification ensured that my credentials were always accurate and up to date. I couldn’t ask for a better partner!
Dentist
Our Customer
I’ve had an outstanding experience with Credex Healthcare. They took over my credentialing, managed my CAQH profile, and handled my DEA registration with ease. Their team made sure my practice stayed compliant and helped me with network research and application follow-up. I don’t know what I would do without them handling all the administrative tasks!
HomeCare Agency Owner
Our Customer
As a Homecare agency, navigating credentialing and enrollment can be a headache, but Credex Healthcare made it simple and straightforward. They took care of everything from our NPI management to PECOS enrollment, ensuring compliance at every step. Their expertise in primary source verification and network research helped us expand our network, allowing us to provide care to more patients. Highly recommend!
Pediatric Group
Our Customer
Credex Healthcare has been an invaluable partner for our multi-specialty group practice. They handled all our credentialing and enrollment needs, ensuring every provider was up-to-date across insurance networks and credentialing portals like CAQH and PECOS. Their ability to track and manage multiple providers’ licenses and certifications has saved us a tremendous amount of time and reduced our administrative burden.
Lab Director
Our Customer
Running a lab comes with its own set of compliance challenges, but Credex Healthcare has taken care of it all. They managed our CLIA waiver, credentialing, and enrollment processes, ensuring that we met every regulatory requirement. Their attention to detail and ability to handle complex credentialing issues has allowed us to focus on our operations without worrying about missing deadlines or facing compliance issues. Exceptional service!
HomeHealth Agency Owner
Our Customer
Credex Healthcare has been a game-changer for our HomeHealth agency. They managed our credentialing process from start to finish, ensuring all our licenses, DEA registrations, and CAQH profiles were up to date. Their expiration tracking system is incredibly helpful in keeping everything in check. Thanks to them, we can focus on delivering quality care to our patients without worrying about administrative hurdles.
Nurse Practitioner (NP)
Our Customer
Credex Healthcare has been amazing to work with. As a Nurse Practitioner, they took care of everything, from managing my NPI and PECOS enrollment to handling all my licensing and revalidation requirements. Their support has allowed me to concentrate fully on patient care, and their thorough primary source verification ensured that my credentials were always accurate and up to date. I couldn’t ask for a better partner!
Dentist
Our Customer
I’ve had an outstanding experience with Credex Healthcare. They took over my credentialing, managed my CAQH profile, and handled my DEA registration with ease. Their team made sure my practice stayed compliant and helped me with network research and application follow-up. I don’t know what I would do without them handling all the administrative tasks!
Why Credex Healthcare
Achieve application processing at twice the speed of in-house teams
Transparent, fixed pricing per application—no surprise fees
Full support for your billing team at every step
Real-time tracking of application statuses
Personalized service with a dedicated account manager
Immediate alerts for upcoming document expirations
Don’t turn patients away because of a missing contract.
We can secure it for you with the quickest turnaround time and the most competitive rates.
