Credentialing

Credentialing Services for U.S. Healthcare Providers

Expert Credentialing and Payer Enrollment Solutions that Reduce Delays, Ensure Compliance, and Maximize Your Revenue

Book your Free Consultation Now!

    At Health & Billing, we take care of credentialing from start to finish

    So you don’t have to stress over forms, deadlines, or insurance jargon

    • Strategic enrolment into top-paying insurance networks.

    • We specialize in Medicare and Medicaid enrollment, ensuring compliance with CMS

    • CMS, NCQA, and payer requirements met

    • Real-time tracking, secure document storage, and automated reminders.

    • Smooth onboarding and seamless migration with zero disruption to billing or patient care.

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    credentialing delays health and billing

    What If Credentialing Delays Cost Your Practice Thousands?

    Every day your enrollment is delayed, your practice loses money, and patients can’t use their insurance to see you…

    Health & Billing Offer Complete Credentialing Lifecycle Management

    Our credentialing services make it easier for healthcare professionals to join insurance networks. From initial applications to ongoing recredentialing and hospital privileging, our credentialing experts manage every step…

    WHAT YOU WILL GET?

    Primary Source Verification

    Complete verification of medical education. Including residency training, board certifications, and professional licenses through official sources, ensuring bulletproof applications that pass payer scrutiny on the first submission.

    Proactive Re-Credentialing

    We begin the re-credentialing process 90 days before expiration, ensuring zero gaps in network participation and continuous revenue flow for your practice.

    Hospital Privileging Support
    We offer full support! Our comprehensive assistance with medical staff applications ensures that providers have the hospital privileges necessary for comprehensive patient care and optimal reimbursement opportunities.
    Strategic Network Enrollment

    We don't just enroll practitioners everywhere …we strategically target high-value payer networks. Based on your specialty, location, and patient demographics, to maximize your revenue potential from day one.

    CAQH Profile Management
    Ongoing maintenance and real-time updates to provider profiles, ensuring accuracy across all payer networks. We expertly eliminate any delays caused by outdated information.
    Expedited Processing

    Our established relationships with insurance carriers and credentialing organizations enable faster processing times. We leverage industry connections and proven processes to expedite approvals, getting your providers in-network and generating MORE revenue SOONER!

    How to Streamline Payer Enrollment Without Hiring Extra Staff?

    The in-house staff to handle credentialing can cost many practitioners THOUSANDS OF DOLLARS annually!!! PLUS… not including software and training.

    Health & Billing credentialing solutions professionally reduce those costs by up to 40–50%, while improving accuracy and speed.

    WHY CHOOSE HEALTH & BILLING?
    Reduce Your Administrative Burden

    We take over all credentialing paperwork, follow-ups, and status tracking. Freeing your staff to focus on patient care.

    Maximize Your Revenue

    We get you enrolled in the most profitable insurance networks for your specialty and location, ensuring better reimbursement and steady cash flow.

    Compliance Assurance

    Every application is prepared to meet CMS, NCQA, and payer requirements, reducing rejections and keeping your providers fully compliant.

    Faster Processing

    Our established payer relationships typically reduce enrollment timelines by 30–40% compared to self-managed applications.

    Ongoing Support

    Our continuous monitoring, renewals, and updates ensure you stay credentialed without interruptions to revenue.

    Our Technology-Driven Approach

    Automated Tracking

    Advanced tracking systems monitor application status across all insurance carriers, providing real-time updates and proactive follow-up on pending applications.

    Document Management

    Secure, centralized storage of all credentialing documents with automated renewal tracking and maintenance scheduling.

    Compliance Monitoring

    Ongoing monitoring of regulatory changes and carrier requirements ensures your providers maintain a compliant credentialing status.

    Reporting Capabilities

    Comprehensive reporting provides visibility into credentialing status, renewal schedules, and revenue impact of network participation.

    EDI, ERA, and EFT Enrollments
    Our team also manages EDI, ERA, and EFT enrollments to streamline claims submission, accelerate payments, and reduce administrative lag.
    AI-Powered Insights

    Artificial intelligence analyzes credentialing data to identify patterns, predict potential delays, and recommend proactive actions to accelerate approval and reduce revenue risks.

    CREDENTIALING

    Don’t Worry About Switching Services! Our Onboarding Process is Smooth and Fully Managed!

    Whether you are moving from in-house credentialing or another vendor, every document, application, and renewal is transferred flawlessly.. With Health & Billing, your billing never skips a beat, and patient care stays uninterrupted.

    CREDENTIALING

    Who Do We Serve

    We partner with healthcare providers across the United States who want faster, hassle-free credentialing and payer enrollment

    • Physicians & Specialists

    • Locum Tenens & Temporary Credentialing

    • Multi-Provider Practices

    • Medical Groups & Clinic

    • Hospital-Based Providers

    • New Practices & Startup

    why do we serve health and billing

    Health & Billing Offers Complete Contracting & Payer Enrollment Services

    At Health & Billing, we streamline the enrollment of healthcare groups with new payers and insurance networks, managing the entire contracting process from start to finish.
    Once contracts are approved, we ensure accuracy by maintaining and updating fee schedules on an annual basis.
    Our team also takes a proactive role in managing contracts and negotiating reimbursements, optimizing terms, preventing revenue loss, and securing the best possible outcomes for your practice.

    What Happens If You Miss a Recredentialing Deadline?

    Missing a payer recredentialing deadline can result in providers being TERMINATED from networks, leading to denied claims and loss of patient trust. Our automated systems track every deadline and ensure timely submission, eliminating the risk of interruptions.

    OTHER CREDENTIALING CHALLENGES WE EXPERTLY HANDLE:

    Incomplete Application Rejection
    We prevent costly delays by making sure all documentation is complete and accurate.
    Missed Re-credentialing
    Stay in-network and avoid revenue loss with our automated deadline tracking.
    Slow Processing
    Standard credentialing can take 3–6 months; our expertise often reduces this to just 60–90 days.
    Multi-State Licensing
    Expanding across states? We handle the complex licensing and credentialing for you.
    Confusing Payer Rules
    We navigate each payer’s unique requirements so you don’t have to!
    Changing Regulations
    Credentialing rules and requirements evolve constantly. We stay up to date so your practice remains compliant without interruptions.

    Our Credentialing Process: Step by Step!

    01. Initial Provider Assessment & Strategy01

    • We start with a comprehensive review of your credentials, specialty, and practice goals.
    • Our team identifies the most valuable insurance networks for your practice.
    • The team creates a customized, prioritized enrollment strategy to maximize revenue and patient access faster.

    02. Complete Application Preparation & Documentation02

    • Our credentialing specialists gather and organize all necessary documentation.
    • We ensure every application is complete, accurate, and compliant before submission.
    • We stay up-to-date on each payer’s requirements to prevent delays or rejections.

    03. Primary Source Verification & Fast-Track Follow-Up03

    • We handle verification with medical schools, residency programs, licensing boards, and other primary sources.
    • Our established relationships and proactive approach often accelerate standard verification timelines, getting you approved faster.

    04. Application Submission & Real-Time Monitoring04

    • Applications are submitted through the correct channels with proper tracking of submission dates, follow-up tasks, and decision timelines.
    • We maintain constant communication with payer credentialing departments to keep the process moving.

    05. Proactive Follow-Up & Issue Resolution05

    • If questions or issues arise, our team responds immediately with all necessary documentation or clarifications.
    • We anticipate potential roadblocks and resolve them before they delay your enrollment.

    06. Network Activation & Ongoing Maintenance06

    • Once approved, we ensure your network activation is seamless and provide guidance on contract terms, reimbursement rates, and billing requirements.
    • We also manage re-credentialing cycles and ongoing maintenance, keeping your providers in-network and your revenue stream uninterrupted.

    Health & Billing Brings

    Hope, Health & Harmony

    To Your Healthcare Practice
    So, You can focus on what’s more important: Patient Care!

    Reduced Administrative Burden | Improved Cash Flow | 100% HIPAA-compliance
    Cost Efficiency | Certified medical coders and credentialing specialists | Scalable Solution