Medical Credentialing Services That Get You Paid Faster.
Every day a provider is uncredentialed is a day no claims can be submitted to that payer. MedVersify manages the complete credentialing and payer enrollment lifecycle — from initial CAQH setup through ongoing revalidation monitoring — so administrative gaps never block your revenue.
We serve solo physicians, multi-specialty groups, telehealth organizations, and health systems across all 50 states. Every specialty. Every payer. Every enrollment stage.
Get Enrolled. Stay Enrolled. Get Paid.
Our credentialing specialists manage the full enrollment lifecycle — initial applications, CAQH maintenance, payer follow-up, and ongoing revalidation monitoring — so you never lose billing access.
- Medicare, Medicaid & all major commercial payers
- CAQH profile management & quarterly attestations
- Revalidation monitoring across all enrolled payers
- Multi-state credentialing for telehealth & groups
- Dedicated specialist assigned to your practice
50
States
Nationwide coverage
500+
Providers
Actively enrolled
1,000+
Payers
Enrollment experience
98%
Retention
Client retention rate
Every Uncredentialed Day Is a Day You Can't Bill
Credentialing isn't a checkbox — it's the gate between your clinical work and your revenue. Delays, lapses, and missed revalidations don't just slow things down. They block claims entirely until resolved.
90–120
Days
Average In-House Enrollment Timeline
Without a credentialing specialist, the average payer enrollment takes 90–120 days. Every one of those days is revenue you cannot collect.
$0
Revenue
Earned While Enrollment Is Pending
No matter how many patients you see, no claims can be submitted to a payer until enrollment is approved. Uncredentialed = unbillable.
0%+
Practices
Hit by Credentialing-Related Denials
Over 45% of practices experience claim denials directly tied to enrollment gaps, expired CAQH data, or missed revalidation cycles.
$0K+
Lost
Estimated Revenue Lost Per Delayed Provider
A single physician generating $600K annually loses roughly $150K for every 90-day credentialing delay. Multiply that across a group practice.
Medical Credentialing Explained
Medical credentialing is the process by which a healthcare provider establishes their qualifications, licensure, training, and professional history with a payer — and is formally enrolled to participate in that payer's network and receive reimbursement for services rendered to the payer's members.
Every health insurance company — Medicare, Medicaid, and commercial plans — requires providers to complete this process before a single claim can be submitted. There is no workaround. Until enrollment is active, you are out-of-network with that payer, and any claims submitted will be denied or returned unpaid.
Payer enrollment and credentialing are often used interchangeably, but they describe two related activities: credentialing verifies a provider's qualifications; enrollment establishes the formal billing relationship. Both must be completed for a provider to bill in-network.
The process involves collecting extensive documentation — licenses, DEA certificates, board certifications, malpractice history, education and training records — submitting it to each payer in the format they require, following up during review, and then maintaining that enrollment through revalidation cycles that occur every 3–5 years (or immediately when practice information changes).
Why Credentialing Is Complex
- Each payer has its own application format, portal, and documentation requirements
- CAQH profile must be current for most commercial enrollments — outdated profiles stall applications
- Medicare and Medicaid require separate enrollments via PECOS and state-specific portals
- Group and individual enrollments must be managed in parallel and properly linked
- Any change in practice information (address, tax ID, group) may require re-enrollment
- Revalidation deadlines vary by payer and are the sole responsibility of the provider
- Missing or incorrect taxonomy codes are among the most common rejection triggers
- Multi-state practices must comply with each state's unique Medicaid enrollment requirements
The MedVersify Difference
In-house staff managing credentialing alongside other responsibilities is the single largest source of credentialing delays. Our specialists do nothing but credentialing. They know each payer's quirks, follow-up contacts, and processing timelines — and they apply that knowledge exclusively to getting your applications approved as fast as possible.
Complete Credentialing Lifecycle Management
From the first NPI registration to years of ongoing revalidation monitoring, we manage every stage of your credentialing lifecycle so nothing slips through the cracks.
Enrollment Services
Everything required to establish new enrollment relationships with payers — for new providers, new locations, and expanded payer networks.
Initial Commercial Payer Enrollment
We handle applications for all major commercial insurers including Aetna, Cigna, UnitedHealthcare, BCBS, Humana, and regional plans.
Medicare Part B Enrollment
Full CMS 855I/855B application management, PECOS enrollment, and revalidation cycle monitoring.
Medicaid Enrollment (All States)
State-specific Medicaid enrollment, managed Medicaid plans, and dual-eligible program participation.
CAQH Profile Creation & Updates
Initial setup, quarterly re-attestations, document uploads, and proactive expiration management.
NPI Registration & Maintenance
Type 1 (individual) and Type 2 (organizational) NPI registration, taxonomy updates, and address changes.
Group & Individual Enrollment
Separate enrollment tracks for solo providers, multi-physician groups, FQHCs, and hospital-based practices.
Multi-State Credentialing Support
Coordinated enrollment across multiple states for telehealth providers, traveling physicians, and expanding practices.
Locum Tenens Credentialing
Expedited temporary enrollment solutions for locum providers with time-sensitive billing needs.
Ongoing Maintenance
Keeping your existing enrollments current, compliant, and active — so you never lose billing access due to a missed deadline or untracked change.
Revalidation Monitoring & Alerts
We track every revalidation cycle for Medicare, Medicaid, and commercial payers — sending alerts well before deadlines.
Payer Re-Enrollment Management
Changes in tax ID, group structure, or practice address often require full re-enrollment. We manage the entire process.
License & DEA Expiration Tracking
Automated tracking of medical licenses, DEA certificates, board certifications, and malpractice coverage expiration.
Payer Contract Follow-Up
Persistent follow-up with payer contracting departments to prevent applications from stalling or being silently abandoned.
Enrollment Status Reporting
Real-time enrollment dashboards showing application stage, pending items, and projected approval dates.
Primary Source Verification (PSV)
Direct verification of credentials with licensing boards, medical schools, training programs, and malpractice carriers.
CAQH Attestation Management
Quarterly re-attestations handled automatically — your profile never lapses due to a missed deadline.
Change of Information Updates
Address changes, new locations, added payers, and demographic updates submitted across all enrolled payers simultaneously.
A Structured Enrollment Process
Every credentialing engagement follows the same proven workflow — designed to eliminate preventable delays at every stage.
Provider Data Intake
We collect all required provider information: licenses, DEA certificate, NPI numbers, malpractice history, board certifications, medical education, work history, and tax/group identifiers. Our intake checklist eliminates missing data before applications are submitted.
CAQH Profile Setup
We create or update your CAQH ProView profile with complete, accurate data and all required document uploads. A properly maintained CAQH profile is the foundation of any commercial credentialing — errors here cause cascading delays.
Application Submission
We submit clean, complete applications to each payer — reducing back-and-forth and avoiding common rejection triggers like incomplete malpractice history, incorrect taxonomy codes, or missing group-provider linkages.
Proactive Payer Follow-Up
We follow up with payer credentialing departments on a scheduled basis, respond to additional documentation requests immediately, and escalate stalled applications before they expire or get deprioritized.
Approval Confirmation
Upon approval, we confirm effective dates, provider IDs, and network participation status. We deliver a credentialing summary to your billing team so claims can begin the day enrollment activates.
Ongoing Monitoring
Post-enrollment, we monitor revalidation cycles, track credential expirations, manage CAQH re-attestations, and handle any changes to your practice that require payer updates — so your enrollment never lapses.
Credentialing Support for Every Medical Specialty
Different specialties have different payer network requirements, taxonomy codes, and enrollment complexity. Our team has direct experience credentialing providers across every major specialty.
Primary Care / Family Medicine
High-volume E&M and preventive care credentialing
Internal Medicine
Hospitalist and outpatient credentialing support
Cardiology
Interventional and non-interventional enrollment
Orthopedic Surgery
Surgical facility and group enrollment
Behavioral Health / Psychiatry
Parity compliance and telehealth enrollment
Dermatology
Procedural and medical dermatology enrollment
Gastroenterology
ASC and hospital outpatient credentialing
Neurology
Complex neurology payer enrollment
Urgent Care
High-volume multi-site enrollment
Telehealth / Virtual Care
Multi-state credentialing for virtual providers
Oncology / Hematology
Specialty drug enrollment and hospital affiliation
Podiatry
Medicare and Medicaid podiatry enrollment
Radiology
Radiology group and reading provider enrollment
OB/GYN
Obstetric global and GYN procedure credentialing
Physical / Occupational Therapy
Rehab therapy payer network enrollment
Pain Management
Interventional pain and anesthesia enrollment
Ophthalmology
Surgical eye care and optical enrollment
ENT / Otolaryngology
Surgical and audiology credentialing
Don't see your specialty? Contact us — we credential all specialties
Medicare, Medicaid & All Major Commercial Payers
We have active enrollment experience with over 1,000 payer plans nationwide. Below are the major payers and plan types we manage most frequently.
Medicare (CMS)
Part B, DMEPOS, FQHC, and specialty enrollment via PECOS
Medicaid (All 50 States)
State FFS and managed Medicaid MCO enrollment
UnitedHealthcare
UHC, Optum, and United Behavioral Health networks
Aetna / CVS Health
Aetna commercial, Medicare Advantage, and Medicaid plans
Blue Cross Blue Shield
All BCBS regional plans and FEP enrollment
Cigna / Evernorth
Cigna commercial and behavioral health plans
Humana
Humana commercial and Medicare Advantage enrollment
Anthem / Elevance Health
Anthem commercial and Wellpoint plans
Tricare / CHAMPVA
Military and VA-affiliated provider enrollment
Centene Corporation
Ambetter, WellCare, and state plan enrollments
Molina Healthcare
Molina Medicaid and Medicare managed care plans
WellPoint / Simply Healthcare
Regional managed care and exchange plan enrollment
Don't see your payer?
We work with regional and local payers, managed Medicaid MCOs, Medicare Advantage plans, workers' compensation payers, and specialty health plans across all states. If a payer is enrolling providers, we can manage that enrollment for you.
Benefits of Working With MedVersify Credentialing
Most practices don't have a dedicated credentialing specialist on staff. We are that specialist — for every practice we serve.
Faster Enrollment Timelines
Our specialists know payer-specific requirements inside out. Complete, accurate applications and persistent follow-up consistently produce faster approvals than in-house teams managing credentialing as a secondary responsibility.
Zero Missed Revalidations
A single missed revalidation can terminate your Medicare or Medicaid enrollment — requiring you to reapply from scratch. Our monitoring ensures you never face an avoidable re-enrollment from a missed deadline.
Accurate, Complete Applications
The leading cause of credentialing delays is incomplete or inaccurate applications. Our intake process and quality checks eliminate the most common rejection triggers before a single application is submitted.
50-State Coverage
Whether you're a single-state practice or a multi-state telehealth network, we handle credentialing and enrollment across all 50 states with knowledge of each state's Medicaid requirements and licensing board standards.
Seamless Billing Integration
We coordinate directly with your billing team to ensure enrollment effective dates, provider IDs, and payer contracts are in place before claims are submitted — eliminating the billing limbo that causes denials.
Full Visibility at Every Step
You receive enrollment status updates throughout the process. Our reporting tracks each payer application from submission through approval — so you always know where your enrollment stands.
CAQH ProView: The Foundation of Commercial Credentialing
CAQH ProView is the centralized credentialing data repository used by over 1,000 health plans in the United States. When a commercial payer initiates credentialing for a provider, the first thing they do is pull the CAQH profile. If that profile is expired, incomplete, or inaccurate, the credentialing process stalls immediately.
CAQH requires re-attestation every 120 days. Miss the window, and your profile lapses — blocking any payer that relies on CAQH from completing their review. For busy practices managing this internally, missed attestations are among the most common and preventable sources of credentialing delays.
MedVersify manages your CAQH profile completely: initial setup, document uploads, quarterly re-attestations, and real-time updates when your information changes. You never log into CAQH. We handle it.
What We Manage in CAQH
Personal Identification
Name, SSN, NPI, DEA number, state license numbers
Education & Training
Medical degree, residency, fellowship, board certifications
Work History
10-year work history, hospital affiliations, employment gaps explained
Malpractice History
All claims history, current coverage information, carrier details
Practice Locations
All practice addresses, phone, fax, billing and pay-to information
Document Uploads
License copies, DEA certificate, malpractice certificates, CV
Attestations
Quarterly re-attestation before the 120-day expiration window
Medicare & Medicaid Enrollment Services
Government payer enrollment is the most consequential — and most complex — credentialing work a practice undertakes. Medicare and Medicaid enrollment failures affect not just one payer, but your entire patient population that relies on these programs.
Medicare Enrollment
Medicare enrollment is managed through CMS's Provider Enrollment, Chain, and Ownership System (PECOS). The process involves either the CMS-855I (individual), CMS-855B (organizational), or CMS-855O (ordering/referring) application depending on your provider type and billing structure.
We Handle:
- PECOS account setup and application management
- CMS-855I (individual provider) enrollment
- CMS-855B (group/organizational) enrollment
- CMS-855O (ordering and referring) setup
- Medicare revalidation every 3–5 years
- Change of information updates in PECOS
- Medicare Advantage plan enrollment
- DMEPOS supplier enrollment (when applicable)
- OIG exclusion monitoring
Medicaid Enrollment
Medicaid is administered at the state level, meaning requirements, portals, and timelines differ substantially by state. Practices in multiple states, or those serving high Medicaid populations, face significant administrative complexity in managing enrollments across different systems.
We Handle:
- State Medicaid FFS (fee-for-service) enrollment
- Managed Medicaid MCO enrollment (Centene, Molina, etc.)
- All 50 state Medicaid portals and applications
- Dual-eligible program participation
- CHIP (Children's Health Insurance Program) enrollment
- Medicaid revalidation and re-enrollment
- State-specific taxonomy and specialty requirements
- Multi-state Medicaid enrollment coordination
- Medicaid managed care network participation
Medicare Revalidation: The Silent Revenue Risk
CMS requires all Medicare-enrolled providers to revalidate their enrollment every 3–5 years. Failure to revalidate by the CMS-issued deadline results in automatic deactivation of Medicare billing privileges — meaning any claims submitted after the deadline are denied and returned unpaid. Re-enrollment from deactivated status takes the same time as new enrollment, often 60–90 days. MedVersify monitors your revalidation due dates and initiates the process well in advance of deadlines, so deactivation is never a risk.
3–5
Year Revalidation Cycle
Missing the deadline means automatic billing privilege deactivation
Why Outsourcing Credentialing Outperforms In-House Management
| Factor | In-House Credentialing | MedVersify |
|---|---|---|
| Dedicated staff focus | Part-time, split between other duties | 100% credentialing-focused specialists |
| Payer-specific knowledge | Learned through trial and error | Accumulated across 1,000+ payer enrollments |
| CAQH re-attestation management | Frequently missed or delayed | Managed proactively, never lapses |
| Revalidation monitoring | Manual tracking, easily missed | Automated monitoring across all payers |
| Multi-state credentialing | Highly complex, often incomplete | Coordinated across all 50 states |
| Enrollment timeline | 90–120+ days average | Consistently faster through process expertise |
| Staff turnover risk | High — one departure disrupts everything | Zero — institutional knowledge stays with us |
| Cost | Full-time salary + benefits + training | Fraction of one FTE, no overhead |
| Scalability | Requires new hires for growth | Immediately scales with your provider count |
Ready to Stop Letting Credentialing Delays Block Your Revenue?
Schedule a free consultation with a MedVersify credentialing specialist. We'll review your current enrollment status, identify any gaps or upcoming revalidations, and outline exactly how we can accelerate your timeline.
Mon – Fri, 9am–5pm EST
(507) 312-9282Email our team
info@medversify.com- No long-term contracts required
- HIPAA-compliant data handling at every step
- Dedicated specialist assigned from day one
- Response within 24 hours guaranteed
- 50-state coverage, all specialties
Request a Free Credentialing Consultation
Tell us about your practice and current enrollment needs. A specialist will follow up within 24 hours.
HIPAA-compliant. No obligation. Response within 24 hours
Request Received
A MedVersify specialist will review your credentialing needs and reach out within 24 business hours.
Stop Losing Revenue to Enrollment Gaps
Your Patients Are Waiting. Your Enrollment Shouldn't Be.
MedVersify credentialing specialists are ready to take over your payer enrollment — so you can focus on seeing patients while we get you paid for every one.