Medical Credentialing Services for Providers and Practices.
Enrollment, contracting and re-credentialing managed end to end — so your providers get in-network sooner and never drop out by accident.
What our credentialing services include.
Twelve services covering the full credentialing lifecycle: new providers, new locations, renewals and everything in between.
Commercial Payer Enrollment
Applications prepared, submitted and followed up with every commercial plan until the effective date is in writing.
Medicare Enrollment (PECOS)
855I, 855B and 855R filings handled end to end, including reassignment of benefits and revalidation.
Medicaid Enrollment
State-by-state Medicaid and managed-care enrollment, including the paperwork most practices get stuck on.
CAQH Profile Setup & Maintenance
Profile built, attested every 120 days and kept current, because a stale CAQH quietly stalls every application.
NPI Registration (Type 1 & Type 2)
Individual and organizational NPIs registered, updated and tied correctly to your taxonomy codes.
Re-credentialing & Revalidation
Tracked deadlines and early filing so no provider ever drops out of network by accident.
Payer Contracting & Fee Schedule Review
Contract requests, rate comparisons and negotiation support so you're not signing below-market terms.
Hospital Privileging
Privilege applications, committee paperwork and reappointment cycles managed alongside payer work.
Primary Source Verification
Licenses, board certification, education and work history verified to payer and accreditation standards.
License, DEA & Certification Tracking
A live expiry calendar for every provider credential, with reminders well before anything lapses.
Group / Practice Credentialing
New TIN, new location or new group, enrolled and linked properly so claims map to the right entity.
Credentialing Audit & Gap Analysis
A full review of where each provider stands with each payer, and exactly what's blocking the gaps.
How our credentialing process works.
Free credentialing audit
We map every provider against every payer and show you exactly where the gaps are.
Document collection
One organized request for licenses, CVs, insurance and board certifications. Then we take it from there.
Payer enrollment and follow-up
We submit applications and follow up with payers weekly, with a status log you can check any time.
Stay in-network
We track attestations, revalidations and expiries so nothing lapses quietly.
Why practices outsource credentialing to Medfix.
Credentialing delays are silent revenue loss. Every week a provider isn’t in-network is a week of visits billed out-of-network, written off, or not booked at all. We treat payer enrollment like a revenue function, because it is one.
- Weekly payer follow-up
Applications don’t sit in a queue. Someone follows up with each payer by name.
- Nothing expires unnoticed
Licenses, DEA, board certifications and CAQH attestations are tracked on one calendar.
- Billing and credentialing aligned
Because we handle both, claims map to the right TIN, NPI and effective date from day one.
