Question 1

How long does payer enrollment take?

Accepted Answer

Payer enrollment typically takes 60 to 120 days depending on the insurance company. Commercial payers like Cigna and Aetna average 90 days. Medicare PECOS enrollment typically takes 60 to 90 days, and Medicaid enrollment varies by state (30–90 days). ProEnrollment LLC manages the entire process with proactive weekly follow-ups to minimize delays and achieve enrollment 40% faster than industry average.

Question 2

What is CAQH ProView and why do I need it for credentialing?

Accepted Answer

CAQH ProView is a centralized credentialing database used by more than 1,000 health plans and hospitals to verify provider credentials. Most commercial payers — including Aetna, UnitedHealthcare, Cigna, BCBS, and Humana — require an active, up-to-date CAQH profile before processing any enrollment application. An outdated or incomplete CAQH profile is the #1 cause of credentialing delays. ProEnrollment LLC handles CAQH setup, data validation, quarterly re-attestation, and ongoing document maintenance.

Question 3

How much do payor credentialing services cost?

Accepted Answer

ProEnrollment LLC offers flexible pricing models: (1) Per-payer enrollment fees for individual applications, (2) Monthly retainer packages starting at competitive rates for ongoing credentialing management, and (3) Flat-rate new practice setup packages that include CAQH, NPI, and multi-payer enrollment. Contact us for a custom quote tailored to your practice size and payer mix.

Question 4

Do you handle credentialing for new medical practices?

Accepted Answer

Yes — new practice setup is one of our core specialties. ProEnrollment LLC handles everything from entity NPI registration and TIN setup to CAQH profile creation, Medicare PECOS enrollment, Medicaid enrollment, and commercial payer applications with Aetna, UnitedHealthcare, BCBS, Cigna, and Humana. Our new practice packages are designed to get you billing-ready on Day One.

Question 5

What is the difference between payor credentialing and payer enrollment?

Accepted Answer

Payor credentialing is the process by which an insurance company verifies a provider's qualifications, licenses, education, training, and professional history — essentially verifying they are who they claim to be. Payer enrollment is the contracting process that follows credentialing: the provider signs an agreement with the insurance network and becomes eligible to see patients in-network and receive reimbursements. ProEnrollment LLC manages both steps end-to-end.

Question 6

Which specialties do you credential?

Accepted Answer

ProEnrollment LLC credentials providers across all major medical specialties, including: Primary Care, Cardiology, Psychiatry and Behavioral Health, Physical Therapy, Chiropractic, Dermatology, OB/GYN, Pediatrics, Surgery, Urgent Care, Telehealth, Nurse Practitioners (NPs and PAs), Dental, DME suppliers, and Clinical Labs. We also specialize in multi-specialty group practices and multi-state credentialing.

Question 7

Can you credential providers in multiple states simultaneously?

Accepted Answer

Yes. ProEnrollment LLC has credentialed providers across all 50 US states simultaneously. We understand the state-specific Medicaid requirements, MCO participation rules, and commercial payer regional differences that make multi-state credentialing complex. Our record includes credentialing a telehealth platform across 22 states in a single engagement.

Question 8

What insurance payers do you work with?

Accepted Answer

We work with all major commercial and government payers in the United States, including: Aetna, UnitedHealthcare (Optum), Blue Cross Blue Shield (all state plans), Cigna, Humana, Molina Healthcare, Centene, HealthNet, Magellan Health, and all state Medicaid programs. We also manage Medicare enrollment through PECOS and handle CMS 855 applications for all provider types.

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