Provider credentialing that gets you in network sooner
A provider can't bill a payer they aren't enrolled with. Our provider credentialing team handles applications, follow-ups, and renewals so new providers start billing sooner and existing ones stay in network.
- Medicare, Medicaid, commercial
- CAQH upkeep
- Renewal tracking
The problems we hear about most
Before practices come to us for provider credentialing, these are the issues that keep coming up.
Slow, paperwork-heavy applications
Enrollment applications are long, payer-specific, and easy to get wrong. One missing item can reset the clock.
Revenue lost while waiting
Every week a new provider isn't enrolled is a week of visits that can't be billed to that payer.
Missed re-credentialing
Letting a revalidation or CAQH attestation lapse can cause claims to deny without warning.
Everything included in our Provider Credentialing service
Certified billing and coding professionals handle every part of it, with HIPAA-compliant processes throughout.
Commercial payer enrollment
Applications and follow-up with the commercial payers your practice works with.
Medicare and Medicaid
Enrollment and revalidation, including PECOS updates.
CAQH profile management
Profile setup, document uploads, and regular re-attestation.
Re-credentialing
Tracking and filing for re-credentialing before deadlines.
NPI and license updates
NPI records and license details kept current across payers.
Expiration alerts
Advance notice before licenses, certifications, or enrollments expire.
How provider credentialing works with Optima
First, we set up a clear process from day one. That way, your claims keep moving while we get started.
Gather documents
We collect licenses, certifications, and provider details once, in one secure place.
Apply to payers
Applications are prepared and submitted to each payer you choose.
Follow up
We follow up regularly until each enrollment is approved.
Maintain
We track renewals and re-attestations so nothing lapses.
Is provider credentialing right for your practice?
Tap anything that sounds like your practice today.
Let's see if we're a fit
Select the statements that describe your practice to see whether Provider Credentialing would help.
What provider credentialing changes for your practice
Billing sooner
Complete applications and steady follow-up help avoid avoidable delays.
Fewer enrollment denials
Current enrollments and CAQH profiles mean fewer surprises.
Less admin work
Your team doesn't have to chase payer paperwork.
Provider credentialing for 30+ specialties
Our team works by specialty, so they know the codes, modifiers, and payer rules that apply to yours.
Services that work well together
Timelines vary by payer and state, and some take several months. Complete, accurate applications and regular follow-up help avoid extra delays, and we'll keep you updated throughout.
Medicare, Medicaid, and the commercial payers your practice works with. We'll also help you decide which payers to prioritize.
Yes. We set up and maintain CAQH profiles, including document uploads and regular re-attestation.
Yes. We handle individual providers and group enrollments, including adding new providers to existing group contracts.
See what provider credentialing could change. Start with a free audit.
First, we'll review a sample of your claims, denials, and A/R. Then we'll show you where your revenue cycle needs attention.