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Provider Enrollment & Payer Credentialing

Provider enrollment services that get every provider in-network.

Done-for-you enrollment across commercial, Medicare and Medicaid — CAQH, applications, paneling, contracting and follow-up handled end to end, so your providers can bill in-network faster.

Commercial, Medicare & Medicaid Individual & group Flat, transparent pricing
GP

Riverside Group Practice

6 providers · multi-payer
Enrolled & In-Network

Enrolled with

Aetna BCBS Cigna Medicare Medicaid
90–120days / payer
CAQH · PECOSfully handled
Enrollment Managed
HIPAA-CompliantSecure PHI handling
All Major PayersCommercial & government
90–120 DaysTypical per payer
Dedicated SpecialistOne point of contact
Flat PricingNo hidden fees
Clear it up first

Credentialing vs enrollment vs contracting

These terms get used interchangeably, but they're distinct steps — and getting paid in-network usually needs all three. We handle the whole chain.

Step 1

Credentialing

Verification of your license, education, work history, malpractice coverage and background — the proof that you're qualified.

Step 2

Provider Enrollment

Applying to each payer to join their network — the core of what we do, across commercial, Medicare and Medicaid.

Step 3

Paneling & Contracting

Being accepted onto the network and signing the contract that sets your in-network status and reimbursement rate.

Every payer type

Commercial, Medicare & Medicaid — all handled

Each payer type runs on a different system and set of rules. We manage all three so nothing falls through the cracks.

Commercial Payers

Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare/Optum, Humana and regional plans — driven by your CAQH profile.

Medicare (PECOS)

Medicare enrollment and revalidation through the PECOS system for individual providers and groups. See Medicare enrollment.

State Medicaid

State-by-state Medicaid enrollment, including the extra steps and portals each program requires for participation.

What we handle

One team, from application to in-network.

Send us your documents once. We handle the profiles, the applications, every payer and the follow-up — then hand a clean, billing-ready provider to our own billing team so there's no gap between approved and paid.

Map My Payers Free
Included in your enrollment
  • Enrollment strategy & payer planWe map which payers to pursue based on your specialty, state and goals.
  • CAQH profile setup & attestationBuilt or cleaned up and kept current with 120-day re-attestation.
  • Commercial payer applicationsAetna, BCBS, Cigna, UnitedHealthcare/Optum and regional plans.
  • Medicare (PECOS) & MedicaidGovernment-program enrollment and revalidations where you need them.
  • Paneling, contracting & follow-upWe track every application to approval and secure your in-network contract.
  • Maintenance & re-credentialingRevalidations, add-on payers and updates as your practice grows.

Enrolling providers with the payers that matter

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareOptumHumanaTricareMedicareMedicaid AetnaBlue Cross Blue ShieldCignaUnitedHealthcareOptumHumanaTricareMedicareMedicaid
How it works

From free audit to in-network in ~90–120 days

01

Free Audit

We map your target payers, provider types and gaps — no cost.

02

CAQH & Docs

We build or clean your CAQH profile and gather documents.

03

Submit

We file each commercial, Medicare and Medicaid application.

04

Follow-Up

We track and chase every payer to approval and contract.

In-Network

Enrolled, contracted and billing-ready with our team.

Why providers choose us

Enrollment built to get you paid

Enrollment only matters if it turns into in-network status and real reimbursements. Every step we take points at that outcome.

Get a Free Audit

“We don't stop at an approval letter — we stop when you're in-network and billing.”

Our promise to every provider

Every Payer Type

Commercial, Medicare and Medicaid — plus the state-specific quirks each one has.

One Dedicated Specialist

A single point of contact who knows your file end to end.

Real Status Visibility

Know exactly where every application stands, with proactive follow-up.

Billing-Ready Handoff

Approved today, submitting clean claims tomorrow with our billing team.

Transparent Pricing

Flat per-payer pricing quoted after a free audit — no surprises.

HIPAA-Compliant

Your data and PHI handled under strict, compliant processes.

Simple, transparent pricing

Flat per-payer pricing — quoted up front

No percentage of your revenue, no hidden fees. You get a clear price per payer after a free audit, so you know exactly what enrollment will cost before you commit.

  • Free practice audit & payer plan
  • Flat fee per payer application
  • Multi-provider & group discounts
  • CAQH maintenance included
  • No long-term lock-in

Provider enrollment services for US healthcare practices

Provider enrollment is the process that turns a qualified clinician into a billable, in-network provider. Our provider enrollment services handle every step — CAQH, commercial applications, Medicare (PECOS), Medicaid, insurance paneling, contracting and follow-up — so your providers can join insurance networks and get reimbursed without the paperwork consuming your practice.

We work with solo providers, growing groups and brand-new practices nationwide. Not sure where to begin? A quick free practice audit maps exactly which payers to target, in what order, and how long each should take.

Good to know

Provider enrollment FAQs

Provider enrollment services handle the process of applying to insurance payers and getting a provider approved to bill as an in-network participant. That includes CAQH setup, commercial, Medicare and Medicaid applications, insurance paneling, contracting and follow-up until approval.

Credentialing is the verification of a provider's license, education and background. Provider enrollment is the act of applying to a specific payer to join their network. Paneling is being accepted onto that network, and contracting sets your in-network status and reimbursement. Getting paid in-network usually requires all of them, and we manage the full chain.

We enroll providers with major commercial payers such as Aetna, Blue Cross Blue Shield, Cigna and UnitedHealthcare/Optum, plus Medicare (through PECOS) and state Medicaid programs. Available panels vary by state and specialty.

Most payers take about 90 to 120 days per application. The payer sets the timeline, but a complete CAQH profile and active follow-up prevent the errors and gaps that stretch it out for months.

Yes. We enroll individual providers, add providers to an existing group, and set up group enrollment and linkage so claims route correctly under your practice.

CAQH is the profile database most commercial payers use to verify provider information, and it must be re-attested every 120 days. PECOS is the separate system used for Medicare enrollment. We set up and maintain both so your applications keep moving.

Absolutely. New practices are a core focus. We can bundle enrollment with billing setup and website/IT so you can open and start billing insured clients as quickly as possible.

Pricing depends on how many payers and providers you need enrolled. We use transparent, flat per-payer pricing with no hidden fees, and we start with a free practice audit so you know the scope and cost up front.

Free practice audit

See how fast you can get enrolled

Tell us about your practice and we'll map your target payers, a realistic timeline and flat pricing — no cost, no obligation.

  • Payer-by-payer game plan
  • Realistic approval timeline
  • Flat-fee pricing up front

Request your free audit

// takes under a minute

HIPAA-compliant · we never share your information

Get started today

Get your providers enrolled — and paid.

Let our specialists run enrollment across every payer while you focus on care.