Physician Credentialing Services That Get You in Network Fast
You became a physician to treat patients. Not to spend three months chasing payer applications, re-attesting CAQH profiles, and decoding Medicare enrollment forms. We do that part.
Clean Claim Rate
Day Avg Timeline
Specialties Covered
What Credentialing Delays Actually Cost Your Practice
Most physicians underestimate this. A single provider sitting in credentialing limbo costs a practice between $10,000 and $30,000 in unbillable revenue per month, depending on specialty and patient volume. That is not a billing problem. That is a cash flow crisis.
Here is what goes wrong when credentialing is handled in-house or outsourced to the wrong company:
- Applications go out incomplete, triggering payer rejections that restart the 90-day clock.
- CAQH profiles expire during the 120-day re-attestation window because nobody is tracking the deadline.
- Primary source verification stalls when a residency program contact does not respond for weeks, and nobody follows up.
- Medicare and Medicaid enrollments get filed separately from commercial applications, creating coverage date gaps that surface months later as denied claims.
The real risk:
We have seen practices lose six figures in revenue from a single overlooked re-attestation. That specific failure is preventable. We prevent it.
Most practices wait too long to start. Every week of delay is a week
you cannot bill.
What Our Physician Credentialing Services Include
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Provider Enrollment With Commercial Payers
We enroll your providers with Aetna, Cigna, UnitedHealthcare, BCBS, Humana, and all regional and supplemental payers. We manage every application through to an active effective date. Most commercial enrollments take 60 to 90 days. We start immediately.
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Medicare and Medicaid Enrollment
Federal program enrollment follows a separate process with its own documentation requirements. We manage PECOS setup for Medicare and state-specific Medicaid enrollment across all 50 states. Claims before your effective date are permanently unbillable. We make sure your date is confirmed first.
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CAQH ProView Profile Management
The CAQH ProView portal is where most payers pull your credentialing data. It requires re-attestation every 120 days or your active applications freeze. We own this task for you and maintain a re-attestation calendar so it never lapses.
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Re-Credentialing and Ongoing Maintenance
Most payers require re-credentialing every two to three years. DEA licenses, state licenses, and malpractice policies expire on independent cycles. Missing any one triggers contract termination. We track every expiration date for every provider in your practice.
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Payer Contract Negotiation
Getting credentialed is step one. Getting credentialed at the right reimbursement rates is the goal. We negotiate payer contract terms with a focus on fee schedule optimization, especially in specialties where payer rates vary significantly across plans.
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Hospital Privileging
If your providers need hospital privileges alongside payer credentialing, we manage both tracks in parallel. Hospital credentialing committees have separate documentation timelines. Running both at once eliminates sequential delays that add months to the process.
How Our Credentialing Process Works
Every step runs in a defined sequence. No steps skipped, no applications sitting untracked in a payer queue.
Discovery call and practice assessment (Day 1)
We review your current payer contracts, identify enrollment gaps, and confirm which providers need initial credentialing versus re-credentialing. This call takes 30 minutes and gives us everything we need to build your credentialing roadmap.
Document collection and CAQH setup (Days 2 to 5)
We send you a specialty-specific document checklist. You send us the documents. We handle CAQH setup or update your existing profile and verify every application element is complete before anything goes out.
Simultaneous application submission (Days 5 to 14)
We submit to all target payers at once, not sequentially. A dedicated credentialing specialist on your account manages direct communication with payer credentialing departments from day one.
Active follow-up and issue resolution (Days 14 to 90)
This is where most in-house credentialing falls apart. We follow up with every payer on a defined schedule, escalate stalled applications, and resolve information requests within 24 to 48 hours. Primary source verification delays are the single most common cause of extended timelines. We anticipate them and act before they compound.
Effective date confirmation and billing activation (Day 90 to 120)
We confirm your effective date with each payer, provide written documentation, and coordinate directly with your billing team so claims go out the day you are active, not a week later.
Why Small and Mid-Size Practices Choose Docscare
Boutique by design
The large credentialing companies process thousands of providers. Your application is one file in a queue. At Docscare, you have a dedicated specialist who knows your practice, tracks your payer mix, and picks up the phone when you call.
Austin, Texas headquarters
We have direct knowledge of Texas Medicaid, Texas Medical Association payer relationships, and the regional landscape across Austin, Dallas, Houston, and every Texas market. No offshore operation, no impersonal system.
Every specialty, handled
We credential physicians across 45 specialties. Requirements vary significantly by specialty. We know where the payer-specific denial patterns hide and we address them before they cost you time.
99% clean claim rate on billing
If you use Docscare for medical billing and RCM too, your credentialing and billing data stay in sync. That eliminates the most common source of post-credentialing denial management issues: mismatched NPI numbers, incorrect effective dates, and payer contract discrepancies.
Full HIPAA compliance on every document, every transmission, every stored credential. We do not cut corners on compliance to move faster.
Docscare Vs Managing Credentialing In-House
| With Docscare | Managed In-House |
|---|---|
| 90 to 120 day average timeline | 120 to 180+ days without dedicated follow-up staff |
| Dedicated specialist per practice | Shared admin staff handling multiple responsibilities |
| CAQH re-attestation tracked and managed | Frequently missed, causing frozen payer applications |
| Simultaneous payer submissions | Sequential submissions stack delays across providers |
| All expiration dates tracked per provider | Manual calendar often overlooked under workload |
| Texas-specific payer knowledge built in | Generic process with no regional expertise |
What Physicians Say About Working With Docscare
Specialties We Credential
We manage credentialing for physicians and advanced practice providers across all major specialties:
Physicians Credentialing : Common Questions
If your question is not answered here, contact our Credentialing team directly. Most questions
get a same-day response.
How long does physician credentialing take?
Most physician credentialing processes take 90 to 120 days from initial application submission to an active effective date with commercial payers. Medicare enrollment through PECOS typically runs 60 to 90 days. State Medicaid timelines vary from 30 days in some states to 180 days in others. We start all applications simultaneously to reduce sequential delays.
What is the difference between physician credentialing and provider enrollment?
Credentialing verifies a physician’s qualifications including education, training, licensure, and clinical competency. Provider enrollment establishes the physician’s eligibility to bill a specific insurance company. Both are required to see insured patients and receive reimbursements. They run in parallel but serve different functions, and most practices need both before billing begins.
Can I see patients while credentialing is in process?
You can see patients, but you cannot bill their insurance for those visits until your effective enrollment date is confirmed. Any claims submitted before your effective date are permanently denied. No backdating is available. We confirm your effective date before recommending you begin seeing insured patients under a new payer contract.
What is a CAQH profile and why does it matter?
CAQH ProView is a centralized database where most commercial payers retrieve credentialing data during the enrollment process. Without an accurate, up-to-date profile, payer applications stall or get rejected entirely. The profile requires re-attestation every 120 days. Missing that window freezes all active payer applications immediately. We manage your CAQH profile on an ongoing basis so this never becomes a problem.
What happens if I start billing patients before my credentialing effective date?
Claims submitted before your confirmed effective date are permanently denied by the payer. Most payers do not allow backdating, so revenue earned during the waiting period cannot be recovered. This is one of the most costly credentialing mistakes practices make. We confirm each payer effective date in writing before advising you to begin billing.
How much does outsourced physician credentialing cost?
Credentialing service fees vary based on the number of providers, the number of payers, and whether you need initial credentialing, re-credentialing, or both. We offer transparent pricing tailored to your practice size. Most practices find that outsourcing credentialing costs less per month than the internal staff time spent managing it, and far less than a single month of lost revenue from a delayed enrollment.
What documents do you need to start the credentialing process?
Core documents include: state medical license, DEA registration where applicable, NPI number, medical school diploma, residency and fellowship certificates, board certification, malpractice insurance declarations page, and a complete 10-year work history. We send you a complete, specialty-specific checklist on day one so you know exactly what to gather.
Do you handle re-credentialing for existing payer contracts?
Yes. Re-credentialing is required by most payers every two to three years. We track re-credentialing deadlines for every provider in your practice and initiate the process 90 days before each expiration. We also monitor DEA license renewals, state license renewals, and malpractice policy renewals on the same calendar.
Does Docscare handle credentialing for group practices and multi-specialty clinics?
Yes. We credential individual providers, group practices, and multi-specialty clinics across all 50 states. For groups adding new providers, we run multiple credentialing tracks simultaneously rather than sequentially. That approach significantly reduces the overall timeline compared to processing each provider one at a time.
Ready to Get Credentialed Without the Headaches?
We start your credentialing process the same week you reach
out. Every week you wait is revenue
you cannot recover.
Or call us at (214) 646-1606 to speak with our Credentialing specialist today.
