Nationwide Payor Credentialing & Payer Enrollment Services

What Is Payor Credentialing?

Payor credentialing is the formal process by which health insurance companies verify a...'s qualifications — education, licensure, board certifications, malpractice history, and professional standing — before authorizing that provider to join their network. Without completed credentialing, a provider cannot bill that payer for patient services rendered.

Commercial payer credentialing typically takes 60–120 days. Medicare PECOS enrollment takes 45–90 days. ProEnrollment LLC manages both processes end-to-end for physicians, group practices, and healthcare organizations nationwide.

Expert Payor Credentialing Services for Physicians & Clinics

Delayed credentialing costs the average physician practice $10,000–$30,000 per month in lost revenue. ProEnrollment's pre-submission data audit eliminates the #1 cause of delays — CAQH profile mismatches and documentation errors — getting your practice in-network 40% faster than the industry average.

How Does the Credentialing Process Work?

1. Gather & Audit Provider Credentials — State license, DEA, NPI, malpractice, board certs. ProEnrollment audits every document before submission.
2. CAQH ProView Setup & Maintenance — Build or audit your CAQH profile. Queried by 1,000+ health plans; attested every 120 days.
3. Payer-Specific Application Packages — Customized packages for every target payer submitted simultaneously.
4. Submit to All Payers Simultaneously — Medicare PECOS, all Medicaid, and all commercial payers in one submission wave.
5. Proactive Follow-Up Every 7–10 Business Days — Push stalled applications; deficiency responses within 24 hours.
6. Effective Date Confirmation & Billing Activation — Written confirmation before billing begins.

Our Credentialing & Enrollment Services

• Payor Credentialing Services
• Medicare PECOS Enrollment
• Medicaid Enrollment
• CAQH ProView Setup & Management
• Insurance Contract Negotiation
• Re-credentialing & Revalidation
• New Practice Setup Credentialing
• Behavioral Health Credentialing

Credentialing by Medical Specialty

• Psychiatry Credentialing
• Mental Health Credentialing (LPC, LCSW, MFT)
• Primary Care Credentialing
• Cardiology Credentialing
• Physical Therapy Credentialing
• Dermatology Credentialing
• Chiropractic Credentialing
• Pediatrics Credentialing
• Telehealth Credentialing
• Nurse Practitioner & PA Credentialing
• OB/GYN Credentialing
• Surgery Credentialing
• Urgent Care Credentialing
• Dental Credentialing

Why Choose ProEnrollment LLC

• 99.4% application approval rate across all payer types
• 40% faster average credentialing than industry standard
• 500+ providers enrolled, 2,000+ payer enrollments completed across all 50 states
• HIPAA-compliant — BAA executed with every client, secure document handling
• Dedicated specialist assigned to every account — no call centers
• Work begins within 48 hours of engagement
• Flat-fee and monthly retainer pricing — no hidden fees, transparent status updates
• U.S.-based credentialing team

Who We Serve

ProEnrollment LLC's flat-fee model scales from solo providers to high-volume organizations. We serve individual physicians and sole practitioners, group practices managing multi-provider rosters across multiple locations, behavioral health groups, telehealth platforms expanding across states, and MSOs (Management Services Organizations) and RCM companies credentialing providers on behalf of multiple downstream clients. Our per-provider retainer model, dedicated account specialist, and centralized status tracking are built for organizations managing credentialing at scale — not just single-practice billing.

Trusted By Practices Nationwide

What Practices Say About ProEnrollment

Frequently Asked Questions

How long does payor credentialing take?

Commercial payer credentialing typically takes 60–120 days. Medicare PECOS takes 45–90 days. ProEnrollment gets providers credentialed 40% faster.

What is CAQH ProView and do I need it?

CAQH ProView is used by 1,000+ health plans. ProEnrollment handles setup, attestation, and maintenance.

What payers does ProEnrollment work with?

Aetna, UHC, BCBS, Cigna, Humana, and 50+ regional plans, plus Medicare and all 50 state Medicaid programs.

Can ProEnrollment credential providers in all 50 states?

Yes. ProEnrollment handles multi-state licensing and payer enrollment in all 50 states.

What is the difference between credentialing and payer enrollment?

Credentialing verifies a provider's qualifications, licenses, and professional history. Payer enrollment is the contracting process that follows — applying to join an insurance network. You need both completed to bill an insurer; ProEnrollment manages the entire process end-to-end.

Can you help with a brand-new practice that hasn't opened yet?

Yes — new practice setup is one of our most popular services, including entity NPI registration, CAQH creation, and simultaneous payer applications. We recommend starting 90–120 days before your planned opening date.

What happens if a payer rejects an application?

Our 99.4% success rate reflects rigorous upfront document checks that prevent most rejections. In the rare case of a rejection, we identify the cause, correct it, and resubmit at no additional charge.

Contact ProEnrollment LLC