Our Credentialing & Contracting services help providers become enrolled and in-network with insurance payers, allowing them to bill and receive reimbursement for covered services. Services are offered on a per-payer basis with options based on the level of support needed.

Insurance Payer Credentialing

$130 per payer – Application Submission & Contract/Payer Decision

Includes insurance application preparation, submission, and ongoing follow-up through the payer's credentialing and contracting process. This option covers tracking the application status until a final determination is received.

$160 per payer – Credentialing + EFT, ERA & Enrollment

Includes everything in the Application Submission package, plus:

• EFT (Electronic Funds Transfer) enrollment

• ERA (Electronic Remittance Advice) enrollment

• Required payer and clearinghouse enrollments

• Ongoing follow-up until all enrollments are complete

Government Payer Enrollment

State Medicare

• $195 – Medicare application, plus EFT, ERA, and enrollment setup

State Medicaid

• $195 – Medicaid application, plus EFT, ERA, and enrollment setup

Medicare & Medicaid Bundle

• $330 – Medicare and Medicaid applications, plus EFT, ERA, and enrollment setup

What's Included

Depending on the service selected, credentialing may include:

• Provider data collection (NPI, license, taxonomy, demographics, and CAQH)

• Insurance application preparation and submission

• Primary source verification coordination

• Payer follow-ups and status tracking

• Enrollment monitoring (pending, approved, rejected, or requiring rework)

• Contract review and execution

• Fee schedule review (when applicable)

• Effective date tracking and confirmation of active participation

• Corrections or resubmissions if applications are returned or denied

• Ongoing communication with both the provider and payer throughout the process

Group Credentialing is available for practices with five or more providers. Custom pricing is available based on the number of providers and insurance payers.

Our billing and revenue cycle management services provide comprehensive support to ensure accurate claim processing, payment collection, and ongoing account oversight. These services are designed to support the full reimbursement cycle, from verification through final payment and patient balance resolution.

Includes:

• Insurance Verification of Benefits (VOB)

• Primary, secondary claim submission, and courtesy OON billing

• Denial management and appeals

• ERA posting and manual payment posting

• Accounts receivable (AR) follow-up

• Claim status tracking and resolution

• Patient balance oversight and billing support

• Year-End Insurance Reset – Verify active coverage and updated benefits/deductibles before the first session of the new year.

Pricing:
Based on client load. Options available for percentage, flat monthly rate, and hourly.