Credentialing & Payer Enrollment

Provider Credentialing and Contracting That Accelerates Revenue

45-Day Average EnrollmentAll Major PayersCAQH ManagementContract Negotiation

Overview

Provider credentialing delays cost healthcare practices thousands in lost revenue every month. A single provider sitting outside the network for 60 days can mean $30,000 to $100,000+ in delayed collections depending on specialty and volume.

Rafsons Med Billing dedicated credentialing team manages the entire enrollment process from initial CAQH setup through payer application submission, follow-up, and approval. We complete most enrollments in 45 days or less.

Beyond initial credentialing, we handle ongoing re-credentialing cycles, group roster management, and proactive expiration tracking so your providers are never inadvertently delisted from payer networks.

Key Benefits & Outcomes

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45-Day Average Enrollment

Our streamlined process and payer relationships get providers enrolled and billing in an average of 45 days.

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CAQH Profile Management

We set up, maintain, and attest your CAQH profiles to keep enrollment data current and accurate.

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Contract Negotiation

Our contracting specialists negotiate favorable reimbursement rates on your behalf with commercial payers.

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Expiration Tracking

Proactive alerts and management of all re-credentialing cycles, license renewals, and DEA expirations.

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All Payer Types

Medicare, Medicaid, CHIP, and 500+ commercial payers across all 50 states and territories.

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Group Roster Management

Complete group NPI management, provider roster updates, and location changes handled seamlessly.

Our Process

1

Provider Data Collection

We gather all required provider information: NPI, DEA, licenses, malpractice history, education, and work history.

2

CAQH Setup & Attestation

CAQH profile is created or updated and attested. All supporting documents are uploaded and verified.

3

Application Preparation

Payer-specific applications are completed accurately using the most current enrollment forms.

4

Submission & Follow-Up

Applications are submitted to all target payers simultaneously with proactive weekly follow-up on status.

5

Approval & Activation

Upon payer approval, we verify effective dates and confirm the provider is active before billing begins.

Frequently Asked Questions

How long does credentialing typically take?+
Most commercial payers process credentialing in 60-90 days. Our process and payer relationships allow us to complete most enrollments in 45 days or less. Medicare enrollment typically takes 30-60 days with our assistance.
Can you handle credentialing for new practices?+
Yes. We work with new practice startups, established groups, hospitals, health systems, urgent care networks, and individual providers joining existing groups.
Do you negotiate reimbursement rates with commercial payers?+
Yes. Our contracting specialists review your payer fee schedules against Medicare rates and regional benchmarks, then negotiate improved rates. Clients typically see 5-20% improvement in contracted rates.
What happens if a payer denies our credentialing application?+
We investigate the reason for denial, address any deficiencies, and resubmit with supporting documentation. We also explore alternative network participation options while pursuing re-enrollment.

Get Your Providers Billing Faster

Stop losing revenue to credentialing delays. Our team can begin your enrollment process this week.