Medical provider credentialing is the process of verifying a healthcare provider’s qualifications, licenses, certifications, and professional history to meet the standards required by insurance companies, Medicare, and Medicaid. Proper credentialing allows providers to see patients and receive reimbursement for services.

Credentialing is essential for compliance with payer regulations and healthcare standards. Without proper credentialing, doctors and other healthcare providers cannot bill insurance payers, which can lead to delayed payments and lost revenue.

Insurance enrollment involves submitting applications to major payers, Medicare, and Medicaid, managing primary and secondary coverage, handling portal updates, and ensuring all applications are approved so providers can see patients without delays.

The timeline varies by payer but typically ranges from 30 to 90 days. At PMEx, we actively track your applications and follow up with payers to help speed up approvals.

Yes! Our team provides credentialing and enrollment services for doctors, chiropractors, physical and occupational therapists, and other healthcare providers. We tailor our approach to each specialty and practice type.