Credentialing and Enrollment

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Credentialing & Payer Enrollment

Our Credentialing and Enrollment team makes sure healthcare providers are enrolled correctly with both commercial and government payers, minimizing administrative delays and revenue leakage. We take care of the entire life cycle of enrolling with payers from initial application to continual maintenance.

We have been helping practices simplify credentialing processes in all 50 states.

We proactively monitor expiring documents, re-credentialing deadlines, or payer-specific rule changes. By centralizing your enrollment data and automating follow-ups, we eliminate redundant tasks and accelerate time-to-revenue for new providers.

Enrollment with Payer

Full submission of CAQH, Medicare, Medicaid and commercial payer applications. We track each application from submission to approval and handle all follow-ups, reconsiderations, and appeals if delays occur.

Demographics Update

Make real-time updates to provider addresses & NPI, tax IDs, group affiliations, and practice locations across all active payers to avert claim denials or rejections based on out-of-date information.

CAQH Profile/Maintenance

Ongoing management of CAQH profiles including quarterly attestations, document refresh, and responding to payer data requests. We keep your profile "always ready for validation".

EDI and EFT Enrollments

End-to-end setup of Electronic Data Interchange (EDI) for claim submissions and Electronic Funds Transfer (EFT) for automated reimbursements. Includes ERA enrollment for electronic remittance advice.

Insurance Web Logins

Creation, recovery, and centralized management of provider portal credentials for every commercial and government payer. We maintain a secure, shareable vault of logins accessible to your billing team.

Credentialing specialists at AdvancedMD Medical Billing are excited to fast track your revenue cycle.

Payer Enrollment Applications has 98% First-Pass Approval Rate

Dedicated credentialing coordinator assigned to your practice

125 days prior alert on re-credentialing before expiration

Multi-specialty expertise (Primary Care, Surgery, Mental Health, etc.)

Monthly provider enrollment status reports with actionable insights

Q1. How long does payer enrollment typically take?

Commercial payers: 30–90 days. Medicare: 60–120 days. Medicaid: 30–60 days, varying by state. We provide estimated timelines per payer during onboarding.

Q2. What paperwork do I need to get things moving with the credentialing process?

You will need: Signed W-9, voided check or EFT letter, CAQH ID (or we can generate one), state license(s), DEA certificate, malpractice insurance, and board certifications.

Q3. Do you handle CAQH attestation for multiple providers?

Yes. We handle CAQH group profiles of all sizes, which includes quarterly attestations, uploading updated documents and reconciling discrepancies before they set off payer audits.

Q4. Why should I enroll for EDI/EFT through your service?

EDI ensures claims reach the correct payer address electronically. EFT deposits reimbursements directly into your account, eliminating paper checks and reducing days in A/R by 5–7 days on average.

Q5. How can I get the web logins of insurance managed by your team?

We offer an encrypted, secure credential vault (available through your portal) with role-based access. Rest assured you can view, copy, or retrieve password reset requests at any time. We never share credentials outside your approved list.

Q6. Can you enroll providers in multiple states or specialties?

Absolutely. We credential providers in all 50 states, from multi-specialty groups to telehealth-only providers and locum tenens. Every payer enrollment is customized to the provider’s unique practice setup.

"Since partnering with AdvancedMD RCM, our practice's denial rate has dropped by over 40%. Their coding team is meticulous, and the patient help desk has cut our front desk call volume in half. Truly a game‑changer."

— Dr. Sarah Mitchell, Family Medicine

"Credentialing used to take us months. AdvancedMD RCM handled everything from enrollment to out‑of‑network billing, and we started seeing clean claims within weeks. I finally have time to see patients again."

— Dr. James Carter, Orthopedic Surgery

"Their virtual medical assistant and A/R services saved us from a six‑figure backlog. The team is responsive, transparent, and actually understands revenue cycle management from start to finish."