Faster Enrollment and Revenue
Most providers complete credentialing within 6-8 weeks when managed professionally, versus 12+ weeks when handled internally. That translates to weeks of billable patient visits your practice would have lost.
Medical Credentialing Services
Professional medical credentialing services that accelerate provider enrollment
Medical credentialing is the verification and documentation process that confirms a healthcare provider's qualifications, licenses, and training before that provider can practice and receive insurance reimbursement. Without it, qualified physicians, nurse practitioners, and other clinical staff cannot legally bill insurers or see patients through most networks.
In short: if a provider isn't credentialed, they can't get paid, and your practice can't grow.
Perform Practice Solutions offers dedicated medical provider credentialing services that handle the paperwork, verification delays, and payer requirements so your practice can focus on patient care instead of chasing documents across multiple state and federal databases.
Why It Matters
Why medical credentialing matters for your practice
Healthcare providers across the United States face credentialing as a mandatory regulatory step, yet it remains one of the most time consuming administrative processes in medicine. Credentialing involves coordinating documents from medical schools, residency programs, licensing boards, malpractice carriers, and multiple insurance companies. A missing signature or an incomplete application can send the entire file back to the beginning. Meanwhile, your new provider sits idle, unable to generate revenue or treat patients.
Working with a professional partner for your medical billing and credentialing services removes that friction and protects your practice in three key ways:
Reduced Compliance Risk
A credentialing error can trigger insurance denials or put your practice out of network with major payers. Professional credentialing ensures every requirement is met the first time across every plan you contract with.
Complete Documentation Trail
Credentialing services maintain organized, auditable records of every step, protecting your practice during insurance audits or regulatory inquiries.
Practices that outsource credentialing report fewer enrollment rejections and faster turnaround on high-priority network contracts, which directly impacts cash flow during provider onboarding.
How It Works
How Perform Practice Solutions medical credentialing services work
Step 1
Initial Information Gathering and Timeline Planning
The process begins with collecting all required information from the provider. This includes education history, training details, licensing numbers, malpractice insurance information, and DEA/state board certifications. A credentialing specialist in your region reviews what you have, identifies gaps, and creates a tailored timeline so you understand when enrollment is realistic. This step sets expectations and prevents delays caused by missing or incomplete documentation later.
Step 2
Primary Source Verification
This is where the actual credentialing work happens. Specialists contact medical schools, residency programs, fellowship institutions, and licensing boards directly to verify every credential. They also obtain malpractice insurance verification and confirm board certifications. In the United States, this step requires navigating different state medical board systems, the NPDB (National Practitioner Data Bank), and DEA databases. Each has unique submission processes and timelines. A credentialing service knows exactly how to expedite these requests and follow up when responses lag.
Step 3
Payer-Specific Application Completion
Insurance contracts each have their own enrollment forms and requirements. While the core credential information stays the same, different payers request different documentation, ask for different physician specialties to be listed, or require specific contract language. Your credentialing partner completes each payer application accurately and submits it with the complete verification file, reducing the likelihood of rejection and resubmission cycles that stretch timelines into months.
Step 4
Credential Committee Review and Approval
Most practices require credentialing or peer review committee approval before a provider can be employed or contracted. Your credentialing service prepares the complete credential file with all primary source verifications, ensures it meets your committee's standards, and supports the approval process. This removes the coordination burden from your office manager or HR team.
Step 5
Ongoing Monitoring and Recredentialing
Credentialing doesn't end at enrollment. Medical providers require recredentialing every two to three years, and some payers require updates more frequently. A credentialing service monitors your providers' expiring credentials, initiates recredentialing cycles automatically, and resubmits to payers before contracts lapse. This prevents gaps in coverage that could halt billing.
Why Practices Choose Us
Why practices choose Perform Practice Solutions with their medical credentialing services
Credentialing isn't a side service we offer. It's a core part of what we do every day.
General billing companies often treat credentialing as secondary to billing. They may not know how Medicare credentials a physical therapist versus how a commercial payer handles a behavioral health provider, or which payers in your state require specific documentation and how to push back when an application stalls in internal review.
Perform Practice Solutions only works with insurance billing practices. As a full medical billing and credentialing service, our specialists know your payer landscape, your specialty's requirements, and the fastest realistic path to getting your providers enrolled and earning revenue.
That specialized focus is what separates a credentialing process that wraps up in 90 days from one that drags on for six months or ends in a stack of denied claims.
Payer Networks
Plans and platforms we credential with
From government programs to commercial carriers, BCBS plans, workers' comp, and core credentialing databases — we manage enrollment across the payers and platforms your practice needs.
Government / Public
- Medicare
- Medicaid (state-specific)
- TRICARE
- CHAMPVA
Commercial
- UnitedHealthcare
- Aetna
- Cigna
- Elevance Health (Anthem)
- Humana
- Kaiser Permanente
- Molina Healthcare
- Centene / WellCare / Ambetter
- Health Net
- Oscar Health
Blue Cross Blue Shield Plans (by state, examples)
- BCBS of Texas
- BCBS of Michigan
- Highmark BCBS
- Independence Blue Cross
- Blue Shield of California
- CareFirst BlueCross BlueShield
- Excellus BlueCross BlueShield
- HCSC (Health Care Service Corporation) — runs BCBS IL, MT, NM, OK, TX
Workers' Comp / Auto (PIP)
- State Fund (varies by state)
- Zenith
- Travelers
Credentialing-related (not payors)
- CAQH
- NPPES
- PECOS
Credentialing timeline
As fast as 30 days*
*Subject to accuracy of information received by client.
What Sets Us Apart
What sets Perform Practice Solutions professional credentialing services apart
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Deep Regulatory Knowledge
Specialists understand state licensing requirements, insurance payer networks, and compliance rules. They catch issues internal staff might miss and proactively address them before they cause delays.
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Established Database Relationships
Credentialing firms have direct contacts with medical schools, licensing boards, and payer credentialing departments. This reduces response time from weeks to days in many cases.
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Guaranteed Turnaround
Most reputable services commit to specific timelines and provide transparency on status. You know when to expect enrollment instead of wondering where applications are stuck.
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Multi-Payer Expertise
A credentialing service manages enrollment across dozens of insurance plans simultaneously. Your practice doesn't have to become expert in each payer's unique requirements.
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Error Recovery
When applications are rejected or require revision, credentialing specialists immediately identify what went wrong, correct it, and resubmit. This prevents the common scenario where an incomplete application sits in a payer's queue for weeks.
What Practice Owners Are Saying
Trusted by providers who need enrollment done right
“As a busy PT clinic owner I just did not have the time to navigate the physical therapy credentialing process, so I contacted Perform Practice Solutions. It has been unbelievably helpful and convenient.”
“Opening a new practice can be overwhelming. Perform Practice Solutions was there for me every step of the way, ensuring I was properly credentialed with all the necessary insurance companies.”
“I was initially hesitant to outsource credentialing, but Perform Practice Solutions made the process seamless. Their attention to detail is impeccable.”
FAQs
Frequently asked questions about medical credentialing services
Most providers complete credentialing within 6 to 8 weeks when the process is handled by a professional service. Timeline depends on how quickly primary sources respond and how fast each payer processes applications. Expedited service can sometimes reduce this to 4 to 5 weeks for high priority contracts.
Medical provider credentialing services verify a healthcare provider's education, training, licenses, malpractice history, and board certifications, then manage the applications required to enroll that provider with insurance payers. The goal is to get a provider approved to bill insurance and see patients as quickly and accurately as possible.
Medical billing services manage claims submission, payment posting, and revenue cycle work after a provider is already enrolled with a payer. Medical billing and credentialing services combine that ongoing billing support with the upfront enrollment work that gets a provider approved by insurance companies in the first place. Many practices choose a single medical billing and credentialing service so both functions stay coordinated under one team.
A combined medical billing and credentialing service keeps enrollment status and billing activity connected, which prevents claims from being submitted under expired or incomplete credentials. It also means one team is accountable for the full revenue cycle, from initial enrollment through ongoing recredentialing and claims follow up.
In house credentialing requires staff training, ongoing compliance knowledge, and time to manage multiple databases and payer systems. Outsourced medical billing credentialing services specialize in this work exclusively, stay current on payer requirements, and carry professional liability coverage. Most practices save both time and money by outsourcing.
Get your providers credentialed without the administrative burden
Medical credentialing is too critical to rush and too complex to handle casually. Whether you're onboarding a single provider or scaling your practice, a credentialing service that understands every regulatory and payer requirement saves you weeks of delays and the risk of costly enrollment mistakes.
Ready to streamline your provider enrollment process? Schedule a consultation to discuss your credentialing timeline and learn how professional services can accelerate your provider's path to revenue-generating practice.
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(833) 764-0178
(833) 764-0178
Office
1050 East Flamingo Rd, Suite 107-2470 Las Vegas, NV 89119
1050 East Flamingo Rd, Suite 107-2470 Las Vegas, NV 89119
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