Enrollment & Maintenance

Provider Credentialing Services

Navigate the complex payer enrollment process with our dedicated credentialing experts, ensuring your providers are fully authorized to treat and bill.

Overview

Provider credentialing is a notoriously tedious but absolutely essential part of revenue cycle management. Without proper credentialing, claims will be denied, and revenue will be delayed. Accurex RCM handles the entire lifecycle of provider credentialing and payer enrollment. We meticulously gather documentation, submit applications, track progress with payers, and maintain your CAQH profiles, ensuring that your practice remains in-network and compliant without the administrative headache.

Challenges Addressed

  • Delayed revenue due to uncredentialed providers
  • Missed recredentialing deadlines resulting in network termination
  • Time-consuming phone calls with payer representatives
  • Complex and varying application requirements across different payers
  • Disorganized tracking of provider licenses and expiration dates

Why Accurex RCM

We treat credentialing with the urgency it deserves. By assigning a dedicated credentialing specialist to your account, we ensure that applications don't sit on a desk. We aggressively follow up with payers so your providers can start generating revenue as quickly as the payers allow.

Our Process

1

Information Collection

We securely gather all necessary provider licenses, diplomas, CVs, and practice information.

2

Application Preparation

Our team accurately completes CAQH profiles and specific payer applications.

3

Payer Submission

We submit the completed credentialing packets to the appropriate insurance networks.

4

Application Tracking

We proactively follow up with payers to track the status of the application.

5

Follow-Up

Any requests for additional information from the payer are handled immediately.

6

Enrollment Confirmation

We verify that the provider is loaded into the payer's system with the correct effective date.

7

Ongoing Maintenance

We monitor expiration dates for licenses and manage the recredentialing process.

Frequently Asked Questions

How long does the credentialing process take?
While we submit applications promptly, payer processing times vary widely. It generally takes between 60 to 120 days for a payer to complete the enrollment process, depending on their backlog and the complexity of the application.
Do you handle CAQH updates?
Yes, we fully manage your CAQH profiles, ensuring they are regularly attested and updated with the latest required documentation.
What happens if a provider's license is expiring?
We track all expiration dates for licenses, DEA certificates, and malpractice insurance. We will notify your team well in advance to ensure renewals are completed and updated with the payers.
Can you help credential a new provider joining our established practice?
Absolutely. We specialize in adding new providers to existing group contracts, ensuring they are linked correctly so you can bill for their services.

What We Handle

  • Initial provider enrollment
  • Commercial and government payer enrollment
  • Credentialing application preparation
  • Timely recredentialing management
  • CAQH profile creation and maintenance
  • Provider information updates (demographics, licenses)
  • Payer documentation submission
  • Enrollment status tracking and follow-up
  • Contracting support (where applicable)

Key Benefits

  • Prevention of out-of-network claim denials
  • Significant reduction in administrative workload for your staff
  • Organized and centralized provider documentation
  • Proactive management of recredentialing deadlines
  • Faster path to billing for new providers

Ready to Strengthen Your Revenue Cycle?

Talk with Accurex RCM about the services your practice needs to reduce administrative burden and optimize workflow.

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