Fast-Track Payer Credentialing & Zero-Lapse Provider Enrollment
Eliminate administrative bottlenecks and billing stalls. Our credentialing specialists manage CAQH, PECOS, commercial payer contracts, and hospital privileges across all 50 states with an average 60-day turnaround.
The High Cost of Delayed Credentialing
Physicians who cannot bill directly drain practice operating margins. One administrative filing error can cascade into months of withheld payments and compliance liabilities.
The 90+ Day Billing Freeze
When a new physician joins without completed credentialing, encounters cannot be billed under their NPI. Claims are queued in limbo, producing hundreds of thousands in delayed cash flow.
Payer In-Network Dropping
Lapsed CAQH attestations or expired state licenses cause commercial carriers to unceremoniously drop established doctors to out-of-network status, causing catastrophic retroactive clawbacks.
Application Black Holes
Commercial payer committees meet on strict 30-day cadences. A tiny typo or missing hospital affiliation letter resets the credentialing clock to Day 1 with no advance notice.
Our 4-Stage Turnkey Credentialing Framework
A systematic, auditable roadmap developed over 14 years of direct communication with regional and national payer credentialing committees.
Primary Source Verification & Audit
We perform a granular pre-audit of state medical licenses, DEA registrations, CDS certificates, malpractice loss histories, diplomas, board certifications, and comprehensive CV chronologies to remove anomalies beforehand.
Payer Enrollment & Submission
Complete overhaul of the provider's CAQH ProView profile. Direct submission of Medicare CMS-855I/855R via PECOS, state Medicaid portals, and formal participation applications to designated commercial panels.
Aggressive Committee Follow-Up
Bi-weekly structured outreach to payer network contracting leads and committee specialists. We confirm dossier receipt, resolve reviewer inquiries immediately, and secure official provider numbers (PTANs, NPI links).
Maintenance & Expiration Tracking
Continuous monitoring with 120, 90, 60, and 30-day proactive triggers. We handle mandated quarterly CAQH re-attestations, license renewals, and malpractice certificate uploads with zero administrative burden on clinic staff.
Comprehensive Payer Network Reach
We coordinate directly with commercial health plans, state agencies, and healthcare facility boards to secure par agreements.
Every Program, Carrier, and Facility Privileging Committee
Whether establishing a single provider in a new territory or credentialing a multi-specialty roster across numerous healthcare systems, we ensure complete operational alignment.
Medicare Part A, B & DME
CMS 855I, 855R, and 855B revalidation, PECOS identity verification, and opt-out restorations.
Commercial Carriers
Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Humana, Kaiser, Molina, and regional plans.
Medicaid & State MCOs
Registration in all 50 State Medicaid portals and contracting with relevant managed-care partners.
Hospital & ASC Privileges
Medical staff committee packets, proctoring documentation, peer review references, and hospital bypasses.
Federal, Military & Workers' Comp
Tricare regional contractors, VA Community Care Network (CCN), Department of Labor, and state-level workers' compensation payer panels.
Credentialing Lifecycle Comparison
See why premier medical practices replace internal staff headaches with Mednexa's dedicated payer privileging department.
- check_circle Instant Primary Source Review: Complete background checks and CAQH file updates in under 72 hours.
- check_circle Proactive Twice-Weekly Chasing: Live phone escalation to payer contracting reps before committee cutoffs.
- check_circle 24/7 Client Dashboard Access: Real-time visual tracking of each application's exact status and effective date.
- check_circle Contract Fee Schedule Review: Verification that reimbursement matches optimal market benchmarks.
- cancel Fragmented Multitasking: Credentialing tasks get pushed aside whenever front-desk or billing fires arise.
- cancel Reactive Status Checks: Staff only calls after weeks of silence, discovering missed attestations or bad forms.
- cancel Opaque Spreadsheets: Managing multi-state requirements and re-attestations on manually updated Excel files.
- cancel Take-It-Or-Leave-It Contracts: Commercial agreements signed blindly without fee schedule review or parity checks.
“We brought on 4 new mid-level providers and a pediatric surgeon all in one quarter. Mednexa had all 5 fully credentialed and billing across 14 commercial plans in under 55 days without a single blocked claim. They practically saved our quarterly revenue projections.”
Expand Your Clinical Roster Without Billing Delays
Submit your practice information below. Our credentialing analysts will perform a complimentary audit of your current CAQH roster and provide an exact timeline roadmap within 24 hours.
Audit Request Confirmed!
Our senior credentialing coordinator will contact your practice administration within one business day with your enrollment timeline projection.
2025 Comprehensive Provider Credentialing Checklist
Includes all required documents, NPI registry updates, state license verifications, and attestation schedules needed before onboarding medical providers.