Services
Credentialing that has providers ready to bill on day one
We enroll new providers with your payers, keep CAQH profiles and licenses current, and track every revalidation date so claims are never held up by enrollment.
| Code | What it means |
|---|---|
CARCCO-B7 | Provider not certified or eligible on this date of service |
CARC = claim adjustment reason code, as printed on your remittance.
Credentialing problems show up later as billing problems: claims denied because a provider wasn’t effective yet, or payments stopped because a revalidation was missed.
Medwiser keeps every provider’s enrollment, CAQH profile and renewal dates in one tracker you can see, and follows up with payers until each application is approved.
What's included
- Payer enrollmentApplications for Medicare, Medicaid and commercial plans, submitted and followed up until each provider is effective.
- CAQH ProView managementProfiles completed, documents uploaded and re-attested every 120 days.
- Revalidation and recredentialingMedicare revalidation, commercial recredentialing and license renewals tracked on a calendar you can see.
- Practice and location updatesAddress, tax ID and group changes reported to every payer, so payments keep flowing after a move or acquisition.
- Administrative supportEligibility checks, insurance verification and payer correspondence handled by a team that knows your practice.
Where revenue leaks
The problems we fix
Claims denied because a provider isn't enrolled
Seeing patients before the effective date, or under the wrong group, leads to denials that are hard to recover. We give you each provider's billable date before scheduling starts.
CARCCO-B7Provider not certified or eligible on this date of service
Lapsed CAQH attestation
Payers stop processing recredentialing when a CAQH profile goes un-attested. We re-attest on schedule and keep documents current.
Missed revalidation deadlines
A missed Medicare revalidation can deactivate billing privileges. We track due dates and submit early.
How it works
Getting started with credentialing
Collect documents
One checklist per provider: license, DEA, board certification, malpractice, CV and work history.
Profiles and applications
CAQH, PECOS and payer applications completed and submitted.
Follow up to approval
Every application is followed up on a fixed schedule until there is an effective date.
Maintain
Re-attestations, revalidations and renewals tracked and completed before they are due.
Benchmarks
The numbers we report against
Industry benchmarks and our own service targets. We measure your baseline in a free review and report against it every month.
FAQ
Credentialing & Admin Support: common questions
How early should we start credentialing a new provider?
At least 120 days before their first patient visit. Commercial payers often take 90 days or more to approve.
Can you credential providers in multiple states?
Yes. We handle enrollment for each state's Medicaid program and the commercial plans you work with there.
Do you negotiate payer contracts?
We submit contracting requests and track them, and we can share fee schedule comparisons. Rate negotiation decisions stay with you.
How is credentialing priced?
Per provider per payer for new enrollments, and a monthly fee for ongoing maintenance. We confirm prices once we know your provider count and payer list.
Related services
Often paired with
Medical Billing & Coding
Accurate codes and clean claims, submitted within one business day of the visit.
- Specialty-trained coders
- Claims scrubbed before submission
- Daily charge entry
Prior Authorization
Authorizations requested, tracked and approved before the patient arrives.
- Requirements checked at scheduling
- Requests submitted with clinicals
- Status tracked to a decision
Free credentialing check
Get your providers enrolled and billable
Tell us how many providers and payers you work with, and we will send a timeline and a quote.