Provider Credentialing & Contracting Services
Get Credentialed Faster • Stay Compliant • Maximize Reimbursements
Eliminate payer delays and streamline your provider enrollment process with our end-to-end Credentialing & Contracting Services.
We help physicians, group practices, and hospitals get credentialed quickly so you can focus on patient care, not paperwork.
HIPAA-Compliant | 99 % Approval Rate | Trusted Nationwide
Supporting Healthcare Providers Across the U.S.
What Is Provider Credentialing and Why It Matters
Credentialing is the foundation of every successful healthcare practice. Before a provider can treat insured patients or receive reimbursement, they must be verified and approved by each payer. This includes validating a provider’s education, licenses, certifications, and professional background to ensure compliance with industry and payer standards.
At Expert Medical Billing Services, we simplify this complex process with accuracy and speed. Our credentialing specialists manage the entire workflow from initial applications to final payer approval helping you get in-network faster and stay compliant year-round.
How Our Credentialing & Contracting Process Works
Data Collection & Verification
We gather provider information, licenses, NPI numbers, certifications, malpractice details, and supporting documents to begin enrollment.
Application Preparation & Submission
Our experts complete payer-specific applications, CAQH attestations, and digital forms accurately to avoid rejections or delays.
Payer Follow-Up & Communication
We track each submission in real time, communicate with insurance representatives, and resolve discrepancies immediately.
Contract Negotiation & Enrollment
We review payer contracts for reimbursement accuracy, fee schedules, and compliance before you sign.
Once approved, we secure your in-network status and confirm your effective date.
Re-Credentialing & Maintenance
We manage re-credentialing, renewals, and ongoing compliance documentation ensuring your enrollment remains active year-round.
Common Credentialing Challenges We Solve
Many healthcare providers struggle to manage credentialing internally leading to delayed reimbursements and loss of revenue. Here are the most frequent issues we resolve for our clients:
Incomplete or inconsistent applications: Small data errors or missing fields often cause payer rejections. We ensure 100 % completeness before submission.
CAQH attestation lapses: Providers forget to re-attest every 120 days. We track and update your CAQH profile automatically.
Communication gaps with payers: Long response times and unclear statuses stall enrollment. We maintain active follow-up until final approval.
Renewal deadlines missed: Credentialing renewals and revalidations are tracked through our automated reminders.
Complex multi-payer requirements: Each payer has different formats and timelines. We standardize the process across all networks.
Limited internal staff capacity: Your front office shouldn’t be handling piles of forms we do it all for you.
These problems not only delay credentialing but can lead to lost billing privileges and denied claims. Our proactive approach prevents those revenue leaks before they happen.
Credentialing & Contracting services for all specialties
Comprehensive support
24/7 Access
Personalized Attention
Public Sector
Time-Efficient
Dedicated Experts
Our Technology Advantage
Credentialing used to be slow, paper-heavy, and manual. We’ve changed that.
At Expert Medical Billing Services, we use an AI-assisted credentialing tracker that automates reminders, status updates, and follow-ups across every payer platform.
This technology ensures:
Real-time visibility into credentialing progress
Instant alerts on missing documents or revalidation deadlines
Faster response to payer communications
Secure cloud-based document management
Full HIPAA and CMS compliance
With automation and human expertise working together, our system minimizes delays and provides total transparency for every client.
Why Choose Expert Medical Billing Services?
| Advantage | What It Means for You |
|---|---|
| 99 % Approval Rate | We submit error-free, payer-ready applications |
| Faster Payer Enrollment | Reduce approval times from months to weeks |
| Full-Service Support | From CAQH updates to re-credentialing renewals |
| Transparent Tracking | Real-time progress reports and status updates |
| HIPAA & CMS Compliance | Secure handling of all provider data |
| Nationwide Coverage | serving all 50 states |
Our credentialing and contracting team becomes an extension of your administration, ensuring accuracy, speed, and peace of mind throughout the process.
Get a Complimentary Financial Health Audit for Your Practice
Our Credentialing & Contracting Service Includes
Provider Data Collection & Verification
We ensure all provider information is complete, accurate, and ready for payer submission.
- Provider data collection & document verification.
- Managing licenses, certifications, malpractice details.
- Credentialing for new providers, locations, or group members.
- CAQH registration and attestation updates
Enrollment & Application Processing
We handle every step required to enroll new providers with commercial and government payers.
- New provider enrollment with commercial payers.
- Medicare/Medicaid enrollment
- Payer application preparation and electronic submission.
- Real-time reporting on application progress
Insurance Network Coordination
We manage all communications, follow-ups, and issue resolution with insurance companies.
- Continuous follow-up with insurance networks
- Coordination with credentialing committees
- Immediate resolution of missing or incorrect information
- Tracking submission status across all payers
Contract Review, Privileges & Re-Credentialing
We protect your revenue by ensuring contracts are accurate and credentials remain active.
- Contract review and negotiation support
- Hospital privileges coordination
- Ongoing re-credentialing & maintenance tracking
- Automatic reminders for renewals and revalidations
Industries & Specialties We Support
We support all major medical and dental EHR and billing platforms, including Athenahealth, Kareo/Tebra, eClinicalWorks, AdvancedMD, OfficeAlly, Epic, Cerner, OpenDental, Dentrix, Eaglesoft, CurveHero and more.
Our Clients Are Making Healthcare Better
90 % Reduction in Enrollment Delays | 25 % Faster Payer Approvals | 100 % Renewal Compliance
Frequently Ask Questions
Credentialing verifies a provider’s qualifications; contracting establishes payment terms and reimbursement rates with insurance payers. Both are required for in-network participation.
Typically 45–90 days depending on payer response. Our proactive follow-ups significantly shorten this timeline.
Yes. We manage enrollment and re-validation for both federal and state programs.
Absolutely. We specialize in credentialing for clinics, group practices, and hospitals across multiple states.
Our systems are fully HIPAA and CMS compliant, with encrypted storage and secure document management protocols.
Contact Us
- (321) 594-2213
- info@expertmedicalbillingservices.com
- 915 N Hastings St, Orlando, FL 32808, USA
- 2239 Sherwood Ave SW. Roanoke, VA, 24015