Medical Credentialing Services
Streamline your practice with Code Credentia your trusted partner in healthcare credentialing.
Ready to Transform Your Practice?
Our medical credentialing services are designed to simplify the enrollment process and ensure your providers are ready to bill in record time.
- Faster Payer Enrollment
- Reduce Administrative Burden
- Ensure Full Compliance
- Dedicated Support Team
Request a Credentialing Audit for Your Practice
Our Comprehensive Suite of Physician Credentialing Services
Government Payer Enrollment
We handle the complex process of Medicare and Medicaid enrollment, ensuring your practice is compliant and ready to provide care to government-insured patients.
- Medicare Part A & B Enrollment
- Medicaid State-Specific Applications
- PECOS Data Management
- NPI Registry Maintenance
Commercial Insurance Credentialing
Expand your reach by enrolling with major commercial insurance payers. We manage the entire credentialing cycle from application to contract execution.
- Payer-Specific Applications
- Fee Schedule Negotiations
- Contract Review and Execution
- Network Participation Status
CAQH Registration
A complete and accurate CAQH profile is essential for modern credentialing. We ensure your profile is always up-to-date and verified.
- Initial Profile Setup
- Quarterly Attestation Management
- Document Upload and Verification
- Provider Data Management
Re-credentialing and Clarification
Don't risk losing your network status. We proactively manage re-credentialing cycles and resolve any discrepancies with insurance payers.
- Proactive Cycle Tracking
- Application Submission
- Payer Follow-Up
- Discrepancy Resolution
Hospital Privileges
We assist with the complex process of obtaining and maintaining hospital privileges for your providers.
- Medical Staff Applications
- Primary Source Verification
- Bylaws Compliance
- Ongoing Maintenance
Ongoing Support
Our commitment doesn't end with enrollment. We provide ongoing support to ensure your practice remains compliant and efficient.
- Dedicated Account Manager
- Regulatory Updates
- Practice Growth Consulting
- Custom Reporting
Our Credentialing Process
A streamlined, end-to-end workflow designed to get your providers enrolled faster and keep them compliant year-round.
1. CAQH Profile Management
We handle initial setup and quarterly attestations to ensure your profile is accurate and ready for insurance payers.
2. State/License Verification
Our team verifies all provider licenses and certifications to ensure they meet all state and payer requirements.
3. Payer Management
We manage your presence with all major insurance payers, from initial applications to ongoing maintenance.
4. Application Assistance
We assist with the completion and submission of all enrollment applications, ensuring accuracy and timeliness.
5. Follow Ups
Our team proactively follows up with insurance payers to expedite the enrollment process and resolve issues.
6. Contract Execution
We manage the final stages of the enrollment process, ensuring all contracts are executed and active.
The Code Credentia Advantage
Streamline your provider onboarding with end-to-end credentialing solutions designed to eliminate enrollment delays and maximize cash flow.
Unlimited Managed Enrollment
Complete end-to-end management of all commercial and government payer networks, CAQH profile maintenance, and recurring re-credentialing without restrictions.
Comprehensive Support
Dedicated credentialing specialists assigned to your practice, taking care of application drafting, document gathering, and persistent insurance follow-ups.
Pro-active Verification
Automated primary source verification (PSV), license tracking, and NPI checks to prevent credential lapses and ensure 100% regulatory compliance.
Time-Efficient Turnaround
Expedited submission workflows and clearinghouse setups that cut standard enrollment delays by up to 50%, getting providers active faster.
24/7 Access & Real-Time Tracking
Full visibility into your application pipeline, payer status approvals, document repositories, and expiration alerts anytime through our portal.
Practice Growth Consulting
Strategic guidance for group practice scaling, expanding into new medical specialties, adding associate providers, and optimizing fee schedules.
Meet our Customers
We care what our customers think of us and so should you.
We are partners in your business and your success is ours.
Reasons to Choose Code Credentia
As healthcare shifts to value-based care, Code Credentia provides adaptive solutions that ensure compliance, maximize reimbursements, and support your practice in this changing landscape.
