NPI registration
Type 1 individual and Type 2 group NPIs obtained or corrected, and kept consistent across every payer record you hold.
Home / Provider Credentialing
Provider credentialing services
Every week you are not credentialed is a week you cannot bill.
Curify Solutions handles credentialing and payer enrollment end to end — Medicare, Medicaid, commercial contracts, CAQH, re-credentialing and revalidation — so your providers start earning as early as the payer allows.
Why it matters
Credentialing delays are the most expensive paperwork in healthcare.
A provider who is seeing patients but not yet enrolled is generating cost without generating collectable revenue.
The delay is rarely the payer's fault alone. Applications get returned for a missing malpractice certificate, an unattested CAQH profile or a work history gap that was never explained. Each return can restart the clock rather than continue it, turning a ninety-day process into six months.
We treat the first submission as the one that has to be right, then follow up with payers on a schedule instead of waiting for them to write back.
What is included
Nine things we handle so your staff does not have to.
CAQH ProView setup
Profile built, documents uploaded and attestation kept current. Nearly all commercial credentialing depends on this file being complete and attested.
Medicare enrollment
PECOS applications prepared and filed, including reassignment of benefits and group linkage for new providers joining an existing practice.
Medicaid enrollment
State Medicaid applications handled to the requirements of the specific state, which differ considerably from one another.
Commercial payer contracting
Applications to Aetna, UnitedHealthcare, Cigna, Blue Cross Blue Shield and regional plans, including contract and fee schedule follow-up.
Primary source verification
Education, training, licensure, board certification, DEA registration and malpractice history verified at source, the way payers require.
Hospital privileging
Applications for admitting and clinical privileges prepared and tracked alongside payer enrollment where your providers need both.
Re-credentialing and revalidation
Deadlines tracked and filed ahead of time. A missed Medicare revalidation deactivates billing privileges and stops payment.
Demographic updates
Address, tax ID, group affiliation and roster changes pushed to every payer, so remittances do not start going to an old address.
Realistic timelines
What to actually expect.
Anyone promising faster than this is guessing. These ranges reflect how payers really work, and we plan your start dates around them.
Medicare
PECOS enrollment. Generally the most predictable of the three, provided the application is complete on first submission.
Medicaid
Requirements and processing times differ considerably between states. Some are quick, some run past 120 days.
Commercial payers
Aetna, UnitedHealthcare, Cigna, BCBS and regional plans. Backlogs and closed panels are the usual causes of delay.
Re-credentialing
Every two to three years commercially, five years for Medicare revalidation. Tracked and filed before the deadline.
When to call us
Situations that need credentialing work.
- Opening a new practice and starting from zero
- Hiring a provider who needs enrolling before their start date
- Adding a new location or changing your practice address
- Changing tax ID or group structure
- Expanding into a new state
- A revalidation deadline you have already missed
- Claims denying because a provider is not on file with a payer
- A CAQH profile nobody has attested in over a year
Key benefits
- Enrollment with Medicare, Medicaid and commercial payers
- Paperwork and documentation fully managed
- Faster payments from third-party payers
- Higher reimbursement rates through in-network contracts
- Deadlines tracked so privileges never lapse
- Less administrative burden on your staff
Pairs with billing
Credentialing and billing are usually handled by different vendors, which is how claims end up held for a provider who was enrolled three weeks ago.
When we handle both, enrollment effective dates feed straight into claim submission, and held claims go out the moment they can. Nothing waits for someone to notice the approval came through.
Common questions
What providers ask us first.
What is provider credentialing?
Provider credentialing is the process of verifying a clinician's education, training, licensure, work history and malpractice record, then enrolling them with insurance payers so the payer will reimburse for their services.
Until it is complete, a provider generally cannot bill that payer in network. That is why credentialing delays translate directly into unbilled revenue.
How long does provider credentialing take?
Most commercial payers take 60 to 120 days. Medicare typically takes 45 to 90 days. Medicaid varies significantly by state.
Timelines depend on payer backlogs and on how complete the initial application is. Incomplete submissions are the single most common cause of delay, and a resubmission usually restarts the clock rather than continuing it.
What is the difference between credentialing and payer enrollment?
Credentialing verifies the provider's qualifications. Payer enrollment is the contracting step that adds the provider to the payer's network and sets up billing under that contract.
Both are needed before a provider can bill in network, and they are usually handled together. People use the terms interchangeably, but a provider can be credentialed and still not enrolled.
Can a provider bill while credentialing is still in progress?
It depends on the payer. Some allow retroactive billing back to the application or effective date once approval comes through. Others do not, and anything provided before the effective date is simply not reimbursable.
Because the rules differ by payer and by state, claims held during this window need to be tracked carefully so they can go out before timely filing deadlines pass. This is where practices most often lose money without realising it.
What is CAQH and do we need it?
CAQH ProView is a central database most commercial payers use to pull provider information. Nearly all commercial credentialing depends on a complete and attested CAQH profile.
Profiles must be re-attested regularly. A lapsed attestation can stall a new application or interrupt an existing contract, and it often goes unnoticed until a payer stops paying.
Do you handle re-credentialing and revalidation?
Yes. Commercial payers generally re-credential every two to three years, and Medicare requires revalidation every five years.
We track these deadlines and file ahead of them. A missed Medicare revalidation deactivates billing privileges entirely, and reinstatement takes far longer than filing on time would have.
Get enrolled
Tell us who needs credentialing and where.
Send us your provider list and target payers. We will come back with a realistic timeline and tell you which enrollments to start first.
- Phone720-316-0093
- Alternate Phone720-796-3177
- EmailInfo@curifysolutions.com
- HR EmailHr@curifysolutions.com
- Office1500 N Grant St #6185, Denver, CO 80203