Whether you are just starting or cleaning up years of billing headaches, we have been exactly where you are.
I waited six months for my first insurance patient because nobody told me to start credentialing before I opened. I learned every step the hard way so you don't have to.
The complete sequence. Each step builds on the last. Skip one and the rest stalls.
Your unique 10-digit identifier. You need both Type 1 (individual) and Type 2 (organization). Foundation for everything.
Apply at nppes.cms.hhs.govUniversal credentialing database most payers pull from. Upload license, malpractice, education, and practice info. Keep updated quarterly.
Set up at proview.caqh.orgVerify eligibility, check claims, submit authorizations. Register your practice and connect to each payer.
Register at availity.comApply to each panel individually. BCBS, Aetna, Cigna, UHC, Humana each have their own application and timeline. Some take 30 days. Some take 6 months.
Medicaid is state-specific (TMHP in Texas). Medicare through PECOS. Separate applications and timelines.
Medicare: pecos.cms.hhs.govCredentialing gets you on the panel. Billing gets you paid. EMR config, claim submission, denial management, and payment posting need to be ready before day one.
Most owners spend months navigating portals and chasing payer reps. We do this every day across multiple states.
NPI through confirmation with every payer.
Adding providers and managing CAQH for your team.
EMR config, claim workflows, denials, and AR tracking.
10 new timed codes replacing 92507. We prepare your documentation and workflows.
Reimbursement analysis and strategic panel decisions.
We audit and recover revenue from denials you don't know you have.
Clean claim construction. Documentation standards. Timed code billing for 2027. Authorization tracking. Denial appeals. Benefits verification for front desk. We build SOPs, train your team live, then shadow billing for 30 days.
Credentialing is not fast. But it is predictable.
