Nationwide Payor Credentialing & Payer Enrollment Services

What Is Payor Credentialing?

Payor credentialing verifies a provider's professional qualifications for a health plan. Payer enrollment establishes the provider and billing records for a plan or program. Contracting may be a separate step. The process depends on the provider type, practice location and plan product.

Commercial and Medicare enrollment times depend on the program, provider type and application requirements. ProEnrollment supports provider record review, preparation, payer follow-up and confirmation of participation details.

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 — Track open requests, application references and response deadlines.
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 coding support.

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

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
• Discuss how to transfer supporting records and review any applicable agreements during onboarding
• Dedicated specialist assigned to every account — no call centers
• Agree on the start date, scope and submission priorities
• 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

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