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

ProEnrollment checks application records for mismatched names, addresses and taxonomy codes before submission. It also tracks payer requests and helps you verify the effective date for each plan.

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. Update and attest the profile on the applicable schedule.
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

Now Offering: Complete RCM Medical Billing Services

ProEnrollment LLC now offers complete revenue cycle management medical billing alongside our credentialing services: eligibility verification and authorization, medical billing and coding, accounts receivable management, and CPT certified coding.

• Eligibility Verification & Authorization
• Medical Billing & Coding
• Accounts Receivable (AR) Management
• CPT Certified Coding

Explore all Medical Billing Services | Get a Free Billing Assessment.

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

• Application readiness review by payer and product
• Payer follow-up and deficiency tracking
• Enrollment support for practices across the United 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.

Credentialing Workstreams

What to Track During Credentialing

Frequently Asked Questions

How do I get started with ProEnrollment?

Send your practice state, specialty, provider count and target payers. ProEnrollment can help identify the applications and records that apply to your practice.

What does ProEnrollment handle during enrollment?

ProEnrollment can organize the provider records, prepare applications, track payer responses and help confirm written participation or billing effective dates.

Can I get help with one payer application?

Ask about the target payer and plan product. The required steps depend on your provider type, billing entity, location and whether an existing group contract covers the provider.

What if I already started my own applications?

Share the application references and any notices you have received. A review can separate applications ready for follow-up from ones that need corrected records or a new submission.

Which enrollment work can ProEnrollment support?

The team supports commercial payer enrollment, Medicare PECOS and applicable state Medicaid processes. Share the specific plan and state so the team can confirm scope.

How does ProEnrollment scope a credentialing quote?

Scope depends on provider count, payer products, locations and whether you need new applications, maintenance or group roster changes. See credentialing pricing for the available engagement options.

Can ProEnrollment help an established practice add clinicians?

Yes. Share the existing group contract and billing entity so the team can identify applicable roster, individual credentialing and payer enrollment steps.

When should I contact ProEnrollment about re-credentialing?

Reach out when you receive a re-credentialing notice or want to review renewal dates. Keep the payer notice and your current provider records available.

Can ProEnrollment review existing payer contracts?

Yes. Start with the signed agreement, product names and current fee schedule. See payer contract negotiation support.

What should I send if a payer returns an application?

Share the payer notice, application reference and any response deadline. ProEnrollment can help determine whether the payer needs a correction, supporting documents or a different submission.

Contact ProEnrollment LLC