Get Credentialed and Enrolled Without the Runaround
A provider can't bill a payer until credentialing and enrollment are complete — and the process is full of paperwork, primary-source verification, and payer-specific timelines that are easy to get wrong. We manage the applications, follow-ups, and status tracking so enrollment doesn't stall.
Why Credentialing Timelines Matter
Every day a provider isn't enrolled is a day their services can't be billed. Delays in credentialing translate directly into delayed revenue.
Faster Time to Billing
Applications move forward instead of sitting incomplete.
Fewer Rejected Applications
Documentation is reviewed for completeness before submission.
Status Visibility
You know exactly where each application stands, at any payer.
Fewer Enrollment Gaps
Revalidations and expirations are tracked so coverage doesn't lapse.
Our Credentialing & Enrollment Services
From a new provider's first application to ongoing revalidation.
Initial Credentialing
Applications, licensure, and primary-source verification documents are prepared and submitted.
Payer Enrollment
Applications are filed with each payer and tracked through to an active effective date.
CAQH Profile Management
Provider profiles are kept current so payer verification doesn't stall on outdated data.
Revalidation & Re-Credentialing
Renewal deadlines are tracked ahead of time to prevent lapses in active status.
Our Credentialing Process
A structured process from document collection to an active effective date.
Document Collection
License, DEA, board certifications, malpractice coverage, and work history are gathered.
CAQH & Application Prep
The CAQH profile is built or updated and payer-specific applications are prepared.
Submission & Verification
Applications are submitted, and primary-source verification requests are handled.
Status Follow-Up
Applications are tracked and followed up on until a decision is reached.
Effective Date Confirmation
Contracting and panel loading are confirmed so billing can begin.
Why Practices Trust Claimza With Credentialing
Ready to Move Credentialing Forward?
Whether you're credentialing a new provider or managing revalidations, let's talk about where things currently stand.
+1 786 735 2873 · info@claimzasolutions.com
Provider Credentialing FAQs
Credentialing verifies a provider's license, training, and history. Enrollment links that verified provider to a specific payer — billing can only begin once enrollment reaches its effective date.
It varies by payer. Medicare applications are often processed in roughly 45-60 days, Medicaid in 60-120 days, and commercial payers commonly take 90-150 days, sometimes longer for specialty providers.
Typically an NPI, active license, DEA registration, board certifications, malpractice coverage details, and a complete work history — most of which feeds into the CAQH profile payers reference.
Yes. We track revalidation and re-credentialing deadlines so a provider's active status doesn't lapse.
We follow up directly with the payer to identify the cause — often a documentation gap or outdated CAQH data — and correct it so the application can move forward.
As early as possible. Many practices begin the process 90-120 days before a provider's intended start date to leave room for delays.