Credentialing delays cost your practice thousands per month in lost billings. ClainetRCM handles Medicare PECOS enrollment, CAQH management, and commercial payer credentialing, so you get approved faster and start getting paid sooner.
Tell us about your practice and we'll respond within 24 hours.
For every week a provider is waiting on credentialing approval, your practice loses real revenue. These are the credentialing pain points we hear from providers every day, and exactly what we fix.
Insurance networks can take 90-180 days without expert navigation. In the meantime, providers can't bill, or must work under another provider's NPI, creating compliance risks. We cut that timeline significantly with proactive follow-up.
Each payer has unique applications, portals, and documentation requirements. Keeping track of what's needed, what's missing, and what's expired is a full-time job, and mistakes cause costly rejection cycles.
A single missing document, an outdated CAQH attestation, or a wrong NPI can trigger a denial that restarts the clock entirely. We run a document-by-document review before anything is filed, so these are caught on our desk instead of the payer's.
Licenses, DEA registrations, and payer re-validation deadlines expire silently. Missing a renewal can terminate your network participation overnight, with no advance warning from the payer.
Adding a new provider to your group? Every payer needs to be notified and updated separately. Without a system, onboarding a single physician can take months and dozens of hours of staff time.
Most practices leave their CAQH ProView profile outdated, triggering flags across every payer simultaneously. We maintain, attest, and synchronize your profile so it's never a bottleneck.
Every week a provider sits uncredentialed is a week of visits you cannot bill. Let's start the applications now.
From initial Medicare PECOS enrollment to ongoing re-credentialing maintenance, we own the entire process so your team doesn't have to.
We handle PECOS enrollment, revalidations, and state-specific Medicaid applications, including group and individual NPI enrollments for all provider types.
We enroll your providers with Aetna, BCBS, Cigna, UnitedHealthcare, Humana, plus the regional and specialty payers on your list, handling every application from start to approval.
We track every expiration date in your credentialing profile and initiate renewals proactively, eliminating the risk of a lapsed credential terminating your insurance participation.
An outdated CAQH profile blocks your credentialing across every payer simultaneously. We build, maintain, and attest your profile on your behalf, keeping it always current and complete.
We verify all provider credentials directly from the issuing source, meeting NCQA, URAC, and Joint Commission standards. That supports hospital privileging, delegated credentialing, and payer audits.
Expanding into telehealth or specialty care? We enroll your providers with telemedicine platforms, behavioral health networks, ACOs, and value-based care programs across every state you practice in.
Our process is built to minimize delays, prevent rejections, and keep you informed every step of the way. No surprises, no black holes.
We review your provider profile, specialty, practice locations, and target payer list to build a custom enrollment roadmap.
We provide a custom checklist and gather all required credentials securely: licenses, malpractice, DEA, education, and references.
We set up or optimize your CAQH ProView profile and complete primary source verification before submitting any application.
Applications are completed with meticulous accuracy and submitted simultaneously to all target payers to minimize total enrollment time.
We follow up proactively with every payer's credentialing committee, resolving pend letters, additional requests, and committee questions fast.
Upon approval, we document your effective date, set up re-credentialing reminders, and continue managing your credentials indefinitely.
Hundreds of credentialing companies exist. Here's why providers choose ClainetRCM and stay.
We know what every major payer requires before we submit, so there is no back-and-forth and no missing documents. Our pre-submission quality check prevents the delays that plague most credentialing applications.
You're never left wondering where your application stands. We provide regular status updates and a dedicated point of contact, not a generic support ticket queue.
Our team understands that credentialing exists to enable billing. We prioritize your highest-volume payers first and flag gaps that may be causing silent claim denials.
Whether you practice in one state or need multi-state telehealth credentialing, we handle enrollment nationwide without you needing a different vendor per region.
From solo practitioners just starting out to multi-specialty groups adding providers, our processes scale to any size, with no minimum provider count.
All provider documents are handled in a fully HIPAA-compliant environment. Your credentials and patient information are protected end to end.
Things we control and put in your agreement, not performance stats we can't prove.
Reviewed Document by Document Before Submission
Typical Days to Payer Approval, Industry-Wide
States We Enroll Providers In
Signed With Every Client Before Work Begins
We have credentialing experience across virtually every clinical specialty, including those with unique network requirements or restricted panel enrollment.
We don't just submit paperwork and disappear. We stay engaged until your credentialing is complete. If a payer asks for more information, we handle it at no extra charge.
No commitment required. Response within 24 hours.
Real questions from real providers. If yours isn't here, call us. We love credentialing questions.
The standard industry range is 60-180 days depending on the payer. Medicare PECOS typically takes 30-60 days. Commercial payers vary: Blue Cross and Aetna panels can take 90-120 days. ClainetRCM's proactive follow-up and pre-built payer relationships help most providers get approved within 60-90 days on average.
Generally, no. You cannot bill a payer until credentialed and contracted with them. Some payers offer a retroactive billing provision once approved (Medicare allows billing back to the application date in many cases). We advise on specific payer policies during onboarding so you understand your billing options during the pending period.
Typically: current state medical license(s), DEA certificate, malpractice insurance certificate (current and prior acts if applicable), curriculum vitae, board certification certificate(s), education and training documentation, professional references, and hospital privileges verification if applicable. We provide a complete, specialty-specific checklist at the start of your engagement.
CAQH ProView is a centralized credentialing database used by over 1,000 health plans to verify provider credentials. Nearly every major commercial payer requires an up-to-date CAQH profile before processing your credentialing application. An incomplete or outdated profile causes delays across all payers simultaneously, which is why we manage and attest your CAQH profile as part of our service.
When a denial happens, we immediately investigate the reason, develop a response or appeal strategy, and resubmit at no additional charge. We stay with the case until it's resolved. Common causes of denial (missing documents, outdated CAQH, incorrect NPI data) are caught in our pre-submission review.
Yes. This is one of our most critical services. Most payers require re-credentialing every 2-3 years, and many providers lose network status simply because they missed a deadline. We maintain a compliance calendar for all your credentials, licenses, and payer re-validations, and initiate renewals proactively so you never experience an unexpected gap in participation.
Absolutely. We handle credentialing in all 50 states, including multi-state telehealth enrollment. Each state has different Medicaid enrollment requirements, license portability rules, and commercial payer preferences. Our team manages all of this complexity so you can practice across state lines without the administrative burden.
Our credentialing specialists are ready to assess your enrollment gaps, build a payer strategy, and get your providers approved faster than you thought possible. Free consultation, no commitment.
Send us 90 days of remittance data and we will show you, line by line, which claims were underpaid, denied, or never worked, and what it would take to recover them. No cost, no obligation, and you keep the report either way.