Medicaid and managed care enrollment
State Medicaid enrollment and Medicaid managed care plan participation, handled as the separate steps each state requires.
What's included.
- State Medicaid provider enrollment
- Managed care plan applications and contracting
- Program-specific screening requirements where they apply
Not a guarantee of network acceptance or a substitute for an independent credentialing decision. Payers make all network and credentialing decisions, and requirements vary by payer, product, provider type and state.
Related services.
- 01
CAQH profile setup and upkeep
We build or clean up your CAQH ProView profile so payers find complete, consistent information, and keep re-attestation on schedule.
- 02
Commercial payer enrollment
Applications to commercial health plans for each provider, plan product and practice location you choose, tracked one by one until a decision arrives.
- 03
Medicare enrollment
Practitioner and organization enrollment, reassignment and changes of information through the route Medicare requires for your provider type.
- 05
Group enrollment and affiliations
Linking providers to your group with each payer, so every provider, payer and location combination is enrolled and recorded on its own.
- 06
Payer contracting
Support through the contracting step after credentialing: tracking offers, signatures, countersignatures and effective dates.
- 07
Primary-source verification tracking
A dated record of every verification behind an application: licenses, exclusions, NPI details and other items each payer asks for.
- 08
Recredentialing and revalidation
We watch your recredentialing and revalidation dates and prepare each one well before the payer's deadline.
- 09
Roster updates, location adds and terminations
Keeping payer records current as your practice changes: new locations, demographic updates, roster changes and provider terminations.
Tell us what you're working on.
Share a few details and we'll follow up to talk through scope, timing and next steps. There's no obligation.