Get Started
Medical Credentialing Services

AboutGet Credentialed & Enrolled.
2X Faster and Easier!

Prime Billing is a top-rated Medical Credentialing Service Provider. Our Outsourced Credentialing Services eliminate administrative burdens while also unlocking privileges, ensuring in-network integration, and accelerating reimbursements. Our Provider Credentialing Company has empowered doctors, nurses, and therapists to thrive in their careers. Join the ranks of satisfied practitioners via our Doctor Credentialing and Enrollment Services.
351 +
Happy Customers
402 +
Completed Cases

Schedule Free Credential Consultation

    1st Class Reimbursement

    Enjoy the advantage of first-preference reimbursement rates, maximizing your financial rewards. This means you get paid more for the same services, increasing your profitability and satisfaction.

    Maximum Privileges

    Our streamlined approach not only wins you contracts but also secures vital privileges. You will be able to participate in innovative programs, as well as get incentives for quality performance.

    Billing-Ready

    You'll be prepared to bill from day one, saving you precious time. You will receive a unique provider identification number (PIN) that allows you to submit claims electronically and track them online.

    Swift Reimbursement

    Faster reimbursements ensure a healthy cash flow for your practice. You won't have to wait for months to receive your payments, as we process claims within 15 to 30 days on average.

    Payer Support

    Our advocacy ensures insurance companies stand by you, supporting your needs. We negotiate on your behalf and resolve any issues that may arise, ensuring you get paid fairly and promptly.

    Minimize Denials

    With our expertise, denials become a thing of the past, boosting your efficiency. We verify eligibility, obtain authorizations, and submit accurate claims, reducing errors and rejections.

    Prime Billing Credentialing Services

    We Enroll Providers In Premium Payer Networks In Record Time!

    Credentialing, also known as insurance credentialing or doctor credentialing, is a process that verifies the qualifications, skills, and legitimacy of a healthcare providers. This process ensures that the provider has necessary licenses, certifications, and education to provide healthcare services to patients.

    Only a credentialing provider is eligible to receive payments from the payer and work in compliance with the state and federal regulations. Medical credentialing authorizes physicians to practices in a specific facility and be included in insurance networks like CMS/Medicare, Medicaid, Aetna, Cigna, Humana, UnitedHealthcare, and Blue Cross Blue Shield.

    As a provider, you want fast credentialing so as to start practicing and billing (legally and ethically). But credentialing is a complex process that involves a lot of documentation and verification at different stages by the insurance network. This means a single mistake can result in denials and wastage of resources such as time and money.

    Prime Billing medical billing company offers the best healthcare credentialing solutions. Our professionals handle all the tasks for you, from primary source verification to enrollment in premium payer networks. We do all of this in minimal time and budget.
    Our Medical Credentialing Process

    A Walkthrough of Our Specialist-Vetted
    Provider Credentialing Process

    Prime Billing provider credentialing process is not just a routine procedure, but a validated and certified process that ensures the highest standards of compliance. We have achieved up to 98% success rate of getting providers approved in premium payer networks with maximum privileges in their specific specialties. The process typically includes the following steps:

    1) Surveying the provider

    Our credentialing process begins with an in-depth survey conducted by our credentialing specialists. This process involves comprehensive interviews with providers, gathering essential data such as license numbers, educational history, demographics, and professional background.

    2) Choosing the insurance company

    Our medical credentialing services guide providers in strategically choosing insurance partners aligned with their practice goals and license type, while also finalizing insurance panels based on practice location.

    3) CAQH Enrollment and Management

    We take care of CAQH application submissions, manage ProView accounts, and keep credentials current for smooth primary source verification. We also assist with payer credentialing submissions, ensuring quick insurance panel integration and accurate profiles that enhance network engagement and the quality of patient care.

    4) Ensure Fast Credentialing Approval

    Although the typical timeline is 60-120 days, our provider credentialing experts take proactive steps to accelerate the process. Our team engages in weekly interactions with payers, advocating for the rapid processing and endorsement of your credentialing applications.

    5) In-Network Enrollment

    Upon completing credentialing, your application enters the contract phase. Here, an in-network contract may be offered, including fee schedules and eligible CPT billing codes. We handle closed panel challenges, advocating through appeals to secure your inclusion. With successful credentialing, direct billing becomes feasible, often with preferred reimbursement rates for in-network providers.

    6) Winning you Hospital Privileges Application

    As credentialing wraps up, our active involvement persists. We assist you in gaining all necessary hospital privileges: whether it’s admitting, courtesy, or surgical rights.

    7) Ongoing Monitoring and Updates

    Our continuous oversight ensures that your company’s credentials remain current and that you stay credentialed without interruption. Our experts diligently track your credentialing expirations and conduct comprehensive daily and weekly reviews to maintain your active status. You can rest easy knowing that your credentials are in good hands with us.
    500 +
    Project Completed
    115 +
    HR Consultants
    100 +
    Awards WON
    920 K
    Happy Clients
    Complete Provider Credentialing Solutions

    Helping Health Care Providers With
    All Their Credentialing Needs

    Prime Billing credentialing company offers all-inclusive provider credentialing services for healthcare professionals and organizations. Here’s an overview of the medical credentialing and enrollment services we provide:

    Medicare and Medicaid Provider Enrollment

    We enroll providers in Medicare and Medicaid programs, which are the largest health insurance programs in the US, covering millions of Americans. By enrolling in these programs, providers can expand their patient base, increase their revenue, and comply with federal and state regulations.



    Commercial Insurance Credentialing

    We credential providers with commercial insurance payers like Aetna and Humana, which are private health insurers that offer different plans and networks for their members. By credentialing with these companies, providers can access more patients and negotiate better reimbursement rates.

    NPI Registration (Type 1 and Type 2)

    Our credentialing solutions help individual providers (Type 1) and organizations (Type 2) with obtaining and updating their National Provider Identifier (NPI), which is a unique 10-digit identification number assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS). Having an NPI is required for billing, reporting, and electronic transactions.

    Get credentialed and enrolled 2x faster.

    Let's Talk

    CAQH Registration and Maintenance

    We help providers stand head and shoulders above their peers. Our credentialing specialists register and maintain every provider’s profile on the Council for Affordable Quality Healthcare (CAQH) ProView, which is an online database that collects and verifies provider information for credentialing purposes. By using CAQH ProView, providers can refine their credentialing process with multiple health plans.

    MCR DMEPOS Enrollment

    Providers using our credentialing service can enroll in the Medicare DMEPOS program, which covers items such as wheelchairs, oxygen equipment, braces, and diabetic supplies. By enrolling in this program, providers can offer these items to Medicare beneficiaries, improve their quality of care, and receive reimbursement from Medicare.

    Hospital Privileges

    We facilitate physicians with obtaining and renewing their hospital privileges, which are the rights and responsibilities granted by a hospital to a provider to practice within its facilities. By having hospital privileges, providers can admit and treat patients, access hospital resources, and collaborate with other health care professionals.

    Get credentialed and enrolled 2x faster.

    Let's Talk
    Payer Enrollment and Medical Credentialing for Doctors

    Credentialing and Payer Enrollment Services For All Healthcare Organizations

    Proper credentialing is essential for healthcare providers to deliver quality care, attract patients, and maintain compliance. Our comprehensive credentialing service helps providers of all specialties navigate these challenges. Our payer enrollment credentialing services are available for:

    Physicians

    Our credentialing service ensures physicians gain swift access to insurance networks, accelerating patient care. It's crucial for maintaining credibility and trust with patients and peers.

    PAs/NPs

    Credentialing via our service aids PAs/NPs in expanding their practice reach, ensuring they're authorized to deliver essential medical services independently.

    Hospitals

    Credentialing with us streamlines hospital operations, enabling efficient insurance claims processing and fostering collaboration among medical staff.

    PT/OT/SLP

    Our credentialing facilitates therapists' inclusion in insurance panels, enabling them to offer vital rehabilitation services while maintaining financial stability.

    Podiatrists (DPM)

    Credentialing through us empowers podiatrists to offer specialized foot care, securing their position as recognized experts in their field.

    Chiropractors (DC)

    Our credentialing service solidifies chiropractors' standing in the medical community, granting them access to insurance networks for widespread patient engagement.

    Ambulatory Surgery Centers (ASC)

    Credentialing via our service for ASCs enhances patient trust by demonstrating adherence to rigorous quality standards, crucial for safe surgical procedures.

    Urgent Care Facilities

    Our credentialing ensures urgent care facilities are in-network with insurers, making prompt and affordable medical services accessible to a broader range of patients.

    Diagnostic Testing Facilities

    Credentialing helps diagnostic facilities and clinical laboratories gain insurance approval, increasing patient referrals and enabling prompt diagnosis and treatment.

    Optometrists, Audiologists

    Credentialing broadens the reach of optometrists and audiologists, allowing them to deliver essential eye & ear care services to a more diverse clientele.

    Behavioral Health Providers

    Our credentialing service aids behavioral health providers in becoming part of insurance networks, enabling vital mental health services to reach those in need.

    Get credentialed with maximum privileges.

    Let's Talk
    Complete Payer Support

    Enroll With Your Favorite Payer Through Prime Billing

    Government Payers

    Examples include – Medicare, Medicaid, and TRICARE.

    Commercial Payers

    Examples include – Blue Cross Blue Shield, Kaiser Permanente, Anthem, United Healthcare, Aetna, Cigna, and Humana

    Prime Billing Offers The Best Credentialing Services Near You In The USA

    Looking for the best credentialing solutions by credentialing specialist companies near you? With over a decade of experience, Prime Billing is the best provider credentialing company for practices across all 50 states of the USA.

    We start by thoroughly assessing your specific practice needs and the requirements of your state and the payers you want to work with. From there, we leverage our extensive payer contracts and relationships to compile and verify all necessary documents, licenses, certifications, insurance, and more to meet each payer’s distinct criteria.

    For example, when credentialing a physician in California, we would verify their medical license with the Medical Board of California, check for any disciplinary actions on the National Practitioner Data Bank, review their malpractice insurance coverage, and collect a current CV and diploma before submitting to health plans like Blue Shield of California and Health Net.

    Don’t let the red tape stop your pace.

    Credentialing can be a hassle, but not with us. We have the skills, the tools, and the connections to get you credentialed and enrolled with any payer you want. No matter what your specialty or location, we will enable you enjoy the benefits of being in-network!
    Let's Talk
    Quick Contact

    AboutBook An Appointment

      Contact Info

      Office Address

      30 N Gould St #39988 Sheridan, WY 82801

      Telephone

      (+1) 732 4662541

      Mail Us

      sales@theprimebilling.com