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Medical credentialing services · Payer enrollment · CAQH · Revalidation
PhysiAssist handles provider credentialing from start to finish: payer enrollment with commercial plans, Medicare and Medicaid, CAQH profile upkeep, revalidations and hospital privileges. Applications go out within 5 business days, and every deadline is tracked months ahead.
CAQH and Medicare revalidation tracker
Try itCAQH due
Revalidation
We start
CAQH: every 120 days. Medicare: every 5 years, DMEPOS every 3
The basics
Medical credentialing services verify a provider's licenses, education, board certification and history, and enroll the provider with insurance payers so claims are paid in-network. Ongoing credentialing keeps that status active: CAQH re-attestation every 120 days, Medicare revalidation every 5 years, payer recredentialing and hospital reappointment.
Commercial plans, Medicare through PECOS, and state Medicaid programs.
Profile built, documents current, re-attested before every 120-day deadline.
Due dates tracked and work started 6 months ahead.
Privileging applications and reappointments at hospitals and ASCs.
What we do
| Task | What we do | Our standard |
|---|---|---|
| Document packet | Licenses, DEA, board certification, malpractice, CV and work history | Checklist sent on day one |
| NPI and CAQH | Type 1 and Type 2 NPI checks, CAQH ProView profile built and authorized | Re-attested before every 120-day deadline |
| Commercial payers | Applications, contracts and network participation | Submitted within 5 business days of a complete packet |
| Medicare | Enrollment and reassignment through PECOS, effective date planned | Revalidation started 6 months ahead |
| Medicaid | State Medicaid and managed Medicaid plan enrollment | Tracked to approval and revalidation |
| Hospital privileges | Facility privileging applications and reappointments | Renewal dates tracked |
| Follow-up | Payer status checks until approval, with effective dates confirmed | Status shared with you until approval |
How it works
One credentialing specialist owns each provider file from the first document to the effective date.
We send a checklist and gather licenses, certifications and history once.
CAQH, PECOS and payer applications go out within 5 business days of a complete packet.
We chase every payer until approval and confirm effective dates and provider IDs.
CAQH, revalidation, recredentialing and privileges tracked, with work started early.
Credentialing and billing, one team
When credentialing and billing sit with the same team, no claim goes out for a provider who is not yet active with that payer, and no visit waits on an enrollment nobody is tracking.
The systems we work in every day
We log in to your system; nothing about it changes for your team.
Claims, rejections and remittances worked through your clearinghouse.
Submissions, status checks and renewals in each payer's own portal.
Pricing
Credentialing is quoted per practice, in writing, based on the number of providers, payers and locations, and whether you need new enrollments, ongoing maintenance or both.
It can run on its own or alongside our core billing service, which is priced at 2.8% to 5% of net collections and covers coding, claim submission, payment posting, denials and AR follow-up.
See how pricing works →Medical credentialing services verify a provider's qualifications and enroll them with insurance payers so they can bill as in-network. They include payer enrollment, CAQH profile management, Medicare and Medicaid enrollment and revalidation, recredentialing and hospital privileges.
Most payers take 60 to 120 days to approve enrollment after receiving a complete application. We cannot speed up the payer's review, but we submit within 5 business days of receiving a complete packet and follow up until approval.
CAQH ProView is the shared database most commercial payers use to pull provider credentialing data. Providers must re-attest at least every 120 days. We keep each profile current and re-attest before every deadline.
Medicare requires providers and suppliers to revalidate enrollment every 5 years, and DMEPOS suppliers every 3 years. We track due dates and start revalidation 6 months ahead.
Credentialing verifies qualifications such as licenses, board certification, education and malpractice history. Payer enrollment, sometimes called contracting, is the step that adds the provider to the payer's network so claims pay at in-network rates.
Yes. We prepare and submit hospital and facility privileging applications and track every reappointment date.
It depends on the payer. Medicare can set the effective date up to 30 days before the application is received; many commercial payers do not pay retroactively. Starting early is the safest way to avoid unpaid visits.
Credentialing is quoted per practice, in writing, based on the number of providers, payers and locations, and whether you need new enrollments, ongoing maintenance or both.
Tell us how many providers and payers you have and we will send a written quote.