Provider Credentialing and Payor Enrollment
Provider Credentialing and Payor Enrollment services are crucial parts of starting a healthcare facility, transitioning to a new practice, or adding providers to your established facility. But, it can also be a long process that is stressful and time-consuming.
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We’re excited to help you take the next step toward optimizing your practice and achieving your goals. If you have any questions or would like to learn more about our services, don’t hesitate to contact us.
Provider Credentialing and Payer Enrollment are essential when starting a healthcare facility, transitioning to a new practice, or onboarding new providers. These processes are highly detailed, time-sensitive, and often require ongoing coordination with multiple payers and regulatory platforms.
MedCycle Solutions helps reduce the administrative burden, stress, and time commitment associated with credentialing and payer enrollment. We work directly with providers and administrative teams to gather required information, manage applications, and track progress through completion — helping organizations onboard providers efficiently while maintaining compliance.
Our Provider Credentialing and Payer Enrollment team has experience and relationships with payers, allowing them to cut through the noise and get you credentialed more efficiently.
Why Choose MedCycle Solutions for Provider Credentialing and Payer Enrollment
Get Paid Faster
Timely and accurate Provider Credentialing and Payer Enrollment allows providers to begin practicing and billing sooner. Our structured approach helps reduce delays caused by incomplete applications or missed follow-ups.
Reduce Administrative Burden
Provider Credentialing and Payer Enrollment involve extensive paperwork, documentation review, and payer coordination. By outsourcing these tasks, organizations free internal staff to focus on operations and patient care.
Avoid Costly Errors & Delays
Incomplete submissions, discrepancies, and missed revalidations can lead to delays or denials. Our team manages applications carefully and follows each process through to completion.
Provider Credentialing & Payer Enrollment Services We Offer
Our services may include some or all of the following, as Provider Credentialing and Payer Enrollment functions are inherently interconnected.
Payer Enrollment Services
- Audit of current payer enrollment status
- Apply for provider in-network status under the client’s existing payer contracts
- Complete payer enrollment applications for groups and individual providers
- Manage payer enrollment processes from submission through approval
- Manage re-credentialing and revalidations for providers
- Manage credentialing and enrollment platforms, including but not limited to:
Credentialing – Primary Source Verification
- Obtain primary source verification for:
– State licensure
– DEA
– Identification
– Certifications
- Verify references, education, and work history
- Obtain initial reports from:
– NPDB
– OIG
- Set up providers for continuous monitoring as required
Credentialing – Medical Staff Support
- Review medical staff privilege applications
- Compare delineation of privileges to documented procedure logs
- Track continuing medical education (CME) credits
- Coordinate provider background screening tests and review results
Credentialing – Audit & Consulting
- Audit internal credentialing and enrollment processes
- Review and update privilege forms
- Conduct compliance-focused credentialing audits
How Our Credentialing & Enrollment Services Work
- Assessment & Information Gathering
We review current enrollment status and collect required provider documentation. - Application Management & Verification
Applications are completed, verified, and submitted according to payer and regulatory requirements. - Ongoing Tracking & Follow-Up
Our team monitors application status, responds to payer requests, and manages follow-ups until completion. - Maintenance & Revalidation Support
We assist with updates, revalidations, and ongoing monitoring to help maintain compliance over time.
FAQs
1. What Provider Credentialing and Payer Enrollment services does MedCycle Solutions provide?
We support commercial payer enrollment, Medicare and Medicaid enrollment, CAQH registration, NPI registration (Type I and Type II), revalidations, provider onboarding, primary source verification, medical staff credentialing, and credentialing audits.
2. How does MedCycle Solutions help providers get paid sooner?
By managing applications accurately and consistently, providers can begin practicing and billing once approvals are finalized without unnecessary delays.
3. How does MedCycle Solutions reduce stress for healthcare organizations?
We handle the administrative workload — including documentation, submissions, follow-up, and monitoring — reducing internal strain on staff.
4. Can MedCycle Solutions support multi-provider or multi-location organizations?
Yes. We support organizations of all sizes and can manage the Provider Credentialing and Payer Enrollment across multiple providers, specialties, and locations.
5. What happens if issues or discrepancies are identified during the process?
If unforeseen issues or red flags arise, we work with the client to address them and determine next steps based on scope and complexity.