CREDENTIALING SERVICES
Your practice bleeds while they process paperwork.
Every day without network access is a calculated bet that you’ll hire the wrong staff, miss the deadline, or surrender to the maze designed to exhaust solo practitioners before their first patient sits down.
The application sits there. Your bank account empties here.
Credentialing denial isn’t randomness – it’s predictable friction embedded in a system where one missing form letter costs you three months of operating capital. MD Revenue Group dismantles the bureaucratic architecture strangling your launch timeline, transforming 120-day purgatory into a surgical strike that gets you contracted, enrolled, and collecting before your competitors finish their second re-submission.
13+ years of watching them move the goalposts. We know where they're moving them next.
5 mechanisms that collapse months into weeks.
New Practice Startup Credentialing
We construct credentialing applications the way insurance payers actually process them.
New Provider Additions
Automated expiration tracking and pre-emptive renewal submission 60 days before contract termination.
Re-Credentialing & Renewals
Your Council for Affordable Quality Healthcare profile becomes a proactive tool rather than a neglected liability.
Medicare & Medicaid Enrollment
Medicare PECOS registration and state Medicaid enrollment demand precision most practices discover only after rejection
CAQH Profile Management
Commercial payer contracts arrive with reimbursement rates calculated to benefit them, not you.
What separates those who wait from those who collect.
Reduced Denials
Proper provider credentialing prevents “Provider Not Found” denials, out-of-network rejections.
Faster Turnaround
Our credentialing experience with payer-specific requirements allows us to avoid common application pitfalls.
Cost Efficiency
Save on administrative overhead and staffing costs. No need to hire full-time credentialing staff to manage complex enrollment paperwork.
The questions keeping you from the 'Get Contracted' button.
How long does the credentialing process take?
Industry standard credentialing timeline is 90-120 days, but varies by insurance payer. Our aggressive follow-up process and payer relationships aim to keep this timeline as short as possible.
Can I see patients during credentialing?
Generally, you cannot bill insurance companies for patient services until you are officially credentialed with the plan and have an effective enrollment date. We advise on payer-specific rules to avoid billing compliance issues.
Do you assist with payer contract negotiation?
Yes. For commercial insurance payers, we assist in reviewing fee schedules, analyzing reimbursement rates, and negotiating better payment terms during the contracting and credentialing phase.
What documents are needed for credentialing?
Typically, we need your CV/resume, state medical license, DEA registration, malpractice insurance certificate, board certifications, and NPI number. We provide a comprehensive credentialing checklist during onboarding.
Do you handle CAQH profile maintenance?
Yes. We create new CAQH profiles, update existing provider information, complete attestations, and monitor for expiration notices to keep your credentialing current across all payers.
What happens if credentialing is denied?
We handle credentialing denials by identifying the rejection reason, correcting application deficiencies, and resubmitting with additional documentation to achieve approval.
Stop funding your competitor's patient volume.
Every day you remain out of network is a day your competition collects the patients who would have chosen you if insurance covered the visit.
