Medical Credentialing Services
A provider can't get paid for care they're not credentialed to bill — and credentialing is one of the slowest, most paperwork-heavy parts of running a practice. Applications stall waiting on payer follow-up, CAQH profiles go stale between attestations, and re-credentialing deadlines get missed in the middle of everything else a practice has to manage. Flint RCM handles enrollment, CAQH maintenance, and re-credentialing end to end, with active follow-up so applications don't just sit in a payer's queue.
Built for practices like yours.
- New practices or newly hired providers not yet enrolled with payers
- Groups adding providers who need enrollment handled without disrupting current billing
- Practices that have had a provider drop out of network due to a missed re-credentialing deadline
- Any practice whose CAQH profile has gone stale between attestation cycles
What this fixes.
- Delayed start of billing because enrollment applications are still pending
- CAQH profiles that lapse between required attestations
- Missed re-credentialing deadlines that cause a provider to fall out of network
- Applications stalled in a payer's process with no one following up
The work, in practice.
We manage the credentialing and re-credentialing process end to end — application prep, payer follow-up, and CAQH maintenance — so providers can start billing sooner and stay in-network without a lapse.
- Payer enrollment application preparation and submission
- CAQH profile setup and ongoing attestation maintenance
- Re-credentialing tracking so deadlines don't get missed
- Application status tracking with proactive payer follow-up
- Medicare/Medicaid enrollment coordination (PECOS)
- Initial payer enrollment applications
- CAQH profile setup & attestation maintenance
- Re-credentialing deadline tracking
- Application status follow-up with payers
- Medicare/Medicaid (PECOS) enrollment coordination
- NPI and license verification support
Our process, start to finish.
Application Prep
CAQH data, licensure, malpractice coverage, and required documentation are gathered and verified before anything is submitted.
Submission
Applications are submitted to each payer in the format and channel they require — requirements vary more than most practices expect.
Active Follow-Up
Rather than submit and wait, we follow up with payers on a set schedule while the application is under review.
Network Confirmation
Once approved, effective dates and network participation are confirmed before billing begins under that payer.
Ongoing Re-Credentialing
Re-credentialing timelines and CAQH re-attestation windows are tracked proactively so nothing lapses.
- Application status by payer and provider
- Upcoming re-credentialing and CAQH attestation deadlines
- Time from submission to network confirmation
Common denials we watch for.
Credentialing problems don't usually show up as a single event — they show up later, as denials tied to enrollment status.
- Claims denied because a provider wasn't yet effective with a payer at the time of service
- CAQH attestation lapses (required roughly every 120 days) causing applications to stall
- Incomplete applications missing a required document, restarting the payer's review clock
- Claims billed under the wrong or an unenrolled payer ID after a location or group change
- Network termination from a missed re-credentialing deadline, discovered only after claims start denying
- CAQH attestation deadlines tracked and completed before they lapse
- Applications checked for completeness before submission to avoid restarting payer review
- Effective dates confirmed and documented before a provider starts seeing patients under a new payer
- Re-credentialing deadlines tracked well ahead of expiration, not discovered after a denial
- Payer follow-up scheduled proactively rather than waiting for the practice to notice a stalled application
Rules change by specialty — so does our approach.
Credentialing looks different depending on what you bill. A few specialties where this shows up most:
Works inside the systems you already use.
Credentialing status and effective dates are tracked alongside your billing data in your existing EHR or practice management system — including AdvancedMD, Tebra, athenahealth, eClinicalWorks, DrChrono, NextGen, and Epic — so billing staff always know which payers a provider is actually cleared to bill.
Credentialing, answered.
It varies significantly by payer, sometimes 60 to 120 days or more, which is exactly why active follow-up during the review period matters — a submitted application isn't a finished one.
Yes, including PECOS coordination for Medicare enrollment, alongside commercial payer applications.
Provider licensure, malpractice coverage documentation, CAQH login access if a profile already exists, and basic practice information. We'll walk through the exact list during onboarding.
Yes — re-attesting a lapsed profile and getting it current again is a common starting point, especially for practices that discover the lapse only after claims start denying.
Explore the rest of the revenue cycle.
Get providers credentialed and billing sooner.
We'll review your current enrollment status and flag anything at risk of lapsing.