Medicare & Medicaid Enrollment
We manage the full enrollment process for government programs, including PECOS management and all required documentation to get your providers approved with CMS.
Credentialing & Provider Enrollment
Get Your Providers In-Network Faster. Start Billing Without the Wait
ProtoMed manages the entire provider enrollment and credentialing process paperwork, payer applications, follow-ups, and renewals so your providers get approved quickly and your revenue cycle stays uninterrupted.
Payer Networks Covered
50+
Payer Networks Covered
Government and commercial payers Medicare, Medicaid, BCBS, UnitedHealth, Aetna, Cigna, and regional carriers.
The Challenge
Credentialing Done Right Without Tying Up Your Team
Provider credentialing and enrollment are non-negotiable but they are also time-consuming, detail-heavy, and easy to get wrong. A missed document or an untracked payer deadline can push your approval back by weeks and block your ability to bill entirely.
ProtoMed takes the entire process off your plate. We know what each payer requires, track every application in real time, and follow up persistently so nothing stalls or slips through.
Easy to Get Wrong
Provider credentialing and enrollment are non-negotiable but they are also time-consuming, detail-heavy, and easy to get wrong.
Costly Delays
A missed document or an untracked payer deadline can push your approval back by weeks and block your ability to bill entirely.
Lost Revenue
Provider credentialing delays cost your practice money every single day.
What We Handle
Our Credentialing & Enrollment Services
Provider credentialing and enrollment are non-negotiable but they are also time-consuming, detail-heavy, and easy to get wrong. ProtoMed takes the entire process off your plate.
Commercial Payer Credentialing
From BCBS and UnitedHealth to Aetna, Cigna, and regional carriers we credential your providers across all major commercial insurance networks.
CAQH Profile Setup & Maintenance
We create and keep your CAQH profiles current and accurate, reducing payer processing delays and ensuring your data is always up to date across networks.
NPI Registration & Management
We handle both Type I (individual provider) and Type II (organizational) NPI registrations and keep all associated data aligned with payer requirements.
Re-Credentialing & Renewals
We track expiration dates for all payer contracts and licenses, initiating renewals proactively so your providers never lapse from an active network status.
New Provider & Group Enrollment
Adding a new physician or expanding your group? We handle onboarding enrollment from scratch new providers get into network without disrupting your existing operations.
Know the Difference
Credentialing vs Provider Enrollment: What's the Difference?
These two terms are often used interchangeably but they refer to different processes with different purposes. Both are required, and both need to be managed correctly to keep your practice billing without interruption.
| Credentialing | Provider Enrollment | |
|---|---|---|
| Purpose | Verifies that a provider is qualified and meets the standards required to deliver safe patient care. | Registers a provider with insurance companies and government payers so they can bill for services and receive reimbursement. |
| Who Reviews | Hospitals, health systems, and insurance companies verify licenses, certifications, education, and professional history. | Insurance payers including Medicare, Medicaid, and commercial carriers review and approve the provider's application. |
| Outcome | Provider is approved as qualified to practice and may be granted hospital privileges or accepted into a payer network. | Provider is in-network and authorized to submit claims and receive payment from that payer. |
| Timing | Typically completed before enrollment begins. Credentialing must be established first as a prerequisite. | Follows credentialing. Can take 60–120 days depending on the payer. ProtoMed actively follows up to reduce delays. |
| ProtoMed's Role | We gather all required documents, complete applications, verify accuracy, and submit to each credentialing body on your behalf. | We manage the full enrollment application, track payer status in real time, and handle follow-up until approval is confirmed. |
Our Process
How ProtoMed Handles Your Credentialing & Enrollment
A structured process that moves applications forward at every stage with no chasing paperwork, no missed deadlines, and no revenue gaps.
01
Practice Assessment & Document Collection
We start by reviewing your current credentialing status and identifying every document required for each payer. We provide a clear checklist, follow up on missing items, and verify everything for accuracy before a single application is submitted.
02
Application Preparation & Submission
Our team prepares and submits complete, error-free applications to each target payer Medicare, Medicaid, and all commercial carriers on your list. Every application is reviewed internally before it goes out to eliminate rejections caused by incomplete or incorrect information.
03
Active Payer Follow-Up
We track every application in real time and follow up with payers persistently. When a payer requests additional information or documentation, we respond immediately keeping your application moving and preventing the delays that typically stretch the process into months.
04
Approval Confirmation & Revenue Activation
Once a payer approves your provider, we confirm effective dates, update your records, and notify your billing team so claims can begin immediately. No approval goes untracked and no revenue start date gets delayed by an administrative oversight.
05
Ongoing Maintenance & Re-Credentialing
We continue monitoring your credentialing status after approval tracking contract renewals, license expirations, and recredentialing deadlines. You stay active with every payer you've worked to get into, without the administrative burden of managing it internally.
Credentialing You Can Count On
50+
Payer Networks Covered
All 50
States Served
100%
HIPAA Compliant
30+
Specialties Credentialed
Every Day Without Enrollment is a Day Without Revenue
Credentialing delays keep your providers out of network and your practice unable to bill. ProtoMed moves the process forward handling every application, every follow-up, and every payer requirement so your providers get approved and revenue starts flowing as quickly as possible.
A ProtoMed credentialing specialist will reach out within 24 hours to review your enrollment needs.
100% HIPAA Compliant
50+ Payer Networks
All 50 States
30+ Specialties
No Long-Term Contracts