From CAQH setup to multi-state telehealth enrollment — complete credentialing management that gets you in-network faster, eliminates application errors, and protects your revenue from day one.
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A provider who isn't credentialed with the right payers simply cannot bill — every service rendered becomes an uncompensated loss. Yet the credentialing process is notoriously complex: hundreds of pages of documentation, payer-specific timelines ranging from 30 to 120 days, and zero tolerance for errors that trigger rejections and force you to restart.
EMBS manages the entire credentialing lifecycle — from initial enrollment and CAQH profile management to re-credentialing, hospital privileging, and multi-state telehealth licensure — ensuring every application is complete, accurate, and submitted on time.
Every credentialing scenario your practice will ever face — from onboarding a new provider to telehealth expansion to hospital privileges.
Complete first-time enrollment for new providers joining your practice or starting their own — from NPI registration and CAQH setup through full payer approval.
Payers require re-credentialing every 2–3 years. Missing a deadline can suspend your billing privileges. EMBS tracks every expiration and handles renewals proactively — before they become problems.
Hospital medical staff credentialing is its own complex process — separate from payer enrollment. We manage every step from application through committee review, with rigorous documentation to meet Joint Commission standards.
Telehealth providers face a unique regulatory maze — each state has its own licensure and payer requirements. We manage multi-state credentialing efficiently, keeping you compliant as telehealth parity laws continue to evolve.
New practices, group practices, and multi-specialty groups need both group-level and individual provider enrollments. We manage the full hierarchy — ensuring the NPI Type 2, tax ID, and practice address are correctly linked across all payers.
Getting credentialed is only the first step — the contract you sign determines what you get paid for every procedure, for years. EMBS reviews payer contracts against Medicare benchmarks and advocates for fair reimbursement rates.
A disciplined, documented workflow that eliminates the errors and missing documents that cause enrollment delays.
Credentialing timelines are set by the payers — not by us. What we control is starting with a complete, error-free application so you don't lose weeks to preventable rejections.
One complete service — no hidden fees, no nickel-and-diming for individual payer enrollments.
Complete CAQH Universal Provider Datasource profile creation, population with all required credentials, and ongoing quarterly re-attestation so your profile never lapses.
Complete Medicare Part B enrollment through the Provider Enrollment, Chain, and Ownership System — including group reassignments, opt-out management, and revalidation.
Enrollment with your state Medicaid program and any required managed Medicaid plans — each state portal handled individually with state-specific documentation requirements.
Applications to all major commercial payers — BCBS (all state plans), Aetna, UnitedHealthcare, Cigna, Humana, Tricare, Molina, Centene, and all regional and specialty plans.
Real-time access to your credentialing dashboard — application submission dates, expected timelines, current status per payer, and alerts for pending items needing your attention.
We track every re-credentialing cycle for every payer and proactively initiate renewals 90–120 days before expiration — ensuring continuous enrollment with no billing interruptions.
Initial review of payer contracts against Medicare benchmark rates to identify underpayment risks — with guidance on which contract terms to negotiate before signing.
Upon approval, we deliver all payer IDs and effective dates in a formatted summary and coordinate entry into your EHR or billing software — so claims begin immediately.
A named coordinator manages your entire file — one point of contact who knows every payer, every outstanding item, and every deadline for every provider in your practice.
Credentialing mistakes have a direct, measurable cost. Here is why practices choose EMBS to protect their enrollment status.
Applications returned for errors restart the clock — adding 30–60+ days to your timeline. Our pre-submission audit catches every missing document and inconsistency before it reaches the payer.
We calendar every re-credentialing date, CAQH attestation, license renewal, and DEA expiration — and act 90–120 days in advance, so you never face a billing interruption due to a lapsed enrollment.
Each state has its own licensure and Medicaid credentialing process. We have completed credentialing in all 50 states and keep current with telehealth parity laws and evolving payer policies.
No ticketing queues. No offshore routing. Your named coordinator manages your entire credentialing file and is reachable directly by phone and email whenever you need a status update.
Real-time access to your credentialing tracker — submitted dates, expected approvals, active follow-up notes, and outstanding items — so you always know exactly where each payer stands.
All credentialing files contain sensitive PHI and provider personal data. Every team member is HIPAA-certified. All data transfers are encrypted and governed by signed BAAs.
Credentialing is priced as a flat fee per provider — not a percentage, not a hidden monthly retainer. You know exactly what you're paying before we start. Volume discounts available for groups with multiple providers.
Get My Credentialing QuoteIncluded With Every Credentialing Engagement
Timelines are set by the payers: Medicare typically takes 60–90 days, Medicaid varies by state from 45–90 days, and commercial payers range from 30–120 days. These timelines begin from the date of application — so starting with a complete, error-free application is critical. Applications returned for errors restart the clock, which is the most common source of preventable delays. EMBS conducts a pre-submission audit on every application to eliminate this risk.
CAQH (Council for Affordable Quality Healthcare) maintains the Universal Provider Datasource — a centralized repository of provider credentials that over 1,000 health plans use as the starting point for credentialing. Most commercial payers require an active, complete CAQH profile before they will process an application. CAQH also requires re-attestation every 120 days; a lapsed profile can delay or halt credentialing applications already in progress. EMBS sets up, populates, and maintains your CAQH profile on an ongoing basis.
This depends on the payer and your specific situation. Medicare does not allow retroactive billing in most cases — services rendered before the effective enrollment date cannot be billed. Some commercial payers allow retroactive billing back to the application date if specifically requested. A few payers offer a provisional or "pending" billing status. We advise each practice on their specific situation and, where possible, file for the earliest retroactive effective date to recover revenue during the enrollment window.
Most payers require re-credentialing every 2–3 years. The process typically involves submitting updated credentials, work history, malpractice information, and sometimes peer references. Additionally, CAQH requires re-attestation every 120 days, and DEA registrations, state licenses, and board certifications each have their own renewal cycles. EMBS maintains a master calendar for every provider and initiates renewals proactively — 90–120 days before each deadline — ensuring you never face a billing interruption due to a lapsed enrollment.
Yes. Telehealth multi-state credentialing is one of our specialties. This involves obtaining or verifying state licensure in each state the provider will see patients (some states have expedited processes through the Interstate Medical Licensure Compact), then completing payer enrollment in each state for each payer. We have completed multi-state credentialing across all 50 states and stay current with the rapidly evolving telehealth parity laws and payer-specific telehealth policies.
EMBS monitors every submitted application and responds to requests for additional information within 24 hours. If an application is returned, we identify the specific deficiency, correct it immediately, and resubmit. Because our pre-submission audit catches most issues before they reach the payer, returns are rare. When they do occur, we escalate immediately and notify you — maintaining full transparency throughout the resolution process.
Absolutely — and most practices don't. The fee schedule in your initial payer contract determines your reimbursement rates for every procedure for years to come, and many initial contracts are significantly below what is negotiable. EMBS reviews your payer contracts against Medicare benchmark rates to identify underpayment risks and advises on which terms to negotiate before signing. Payers are more willing to negotiate at the enrollment stage than after you are already in-network.
Start with a free credentialing review — we'll assess your current enrollment status and identify the fastest path to complete payer coverage.
Get My Free Credentialing Review → Or call us now: (321) 594-2213