Healthcare Business Consulting & Licensing

Credentialing, CAQH & Payer Enrollment

Getting paid starts with being in network. We build your CAQH profile, submit Medicare and Medicaid enrollments, and work the commercial payer applications through to an effective date and a contract you can actually bill against.

Understand this service before you buy

Credentialing is how a provider becomes payable. Each payer verifies the provider independently, and each enrollment has its own application, roster and effective date. Nothing bills until the enrollment is approved and linked to the correct group NPI and service location — which is why a clean CAQH profile is worth more than any follow-up call.

  • Price is per provider, per payer — commercial payers do not share approvals.
  • CAQH must be attested and current or every application stalls at the same step.
  • Effective dates control retro-billing; we document the date each payer grants.
  • Group NPI, tax ID and service address mismatches are the most common rejection.

Scope

  • CAQH ProView build, attestation and quarterly maintenance
  • NPI type 1 and type 2 registration and updates
  • Medicare PECOS enrollment, reassignment and revalidation
  • State Medicaid enrollment
  • Commercial payer applications and contract requests
  • Re-credentialing and roster maintenance for groups

Investment

Credentialing begins at $897 for a practitioner's core payer set, with per-payer add-ons quoted in writing. Group and multi-provider rosters are priced by provider count.

Tracking

Every submission is logged with a date, a payer representative name where available, and a follow-up cadence. You receive a status grid rather than a promise.

What you receive

  • Completed CAQH profile with current attestation
  • Submitted Medicare, Medicaid and commercial applications
  • Payer-by-payer status grid with effective dates
  • Copies of every executed contract and welcome letter
  • Re-credentialing calendar

What you need to get started

11 items

Gather these before you begin credentialing, caqh & payer enrollment. Everything below is requested once, in one secure intake — the more of it you have on day one, the faster your file closes.

Identity and credentials

  • Government-issued photo ID for each owner and practitioner
  • Diplomas, transcripts and postgraduate training certificates
  • Current and prior state licenses, DEA and NPI numbers
  • CV in month/year format with every gap explained

Entity and business

  • Articles of organization / incorporation and EIN letter
  • Ownership breakdown with percentages
  • Business address, service locations and lease or deed
  • Malpractice or liability insurance certificate

Disclosures

  • Any prior discipline, malpractice payout, or license action — with dates
  • Any exclusion, sanction or Medicare/Medicaid revocation history
  • Pending applications with other states or payers

Missing something? Start anyway — we will list exactly what is outstanding in one consolidated message.

Are you ready to start? 30-second check

Three questions. We will tell you honestly whether to move forward with credentialing, caqh & payer enrollment today, gather a few things first, or call us before paying anything.

Question 1 of 3

Is your legal entity formed with an EIN issued?

Question 2 of 3

Is there any prior discipline, sanction, exclusion or malpractice payout to report?

Question 3 of 3

When do you need this completed?

0 of 3 answered — your result appears when all three are selected.

Pricing

Credentialing, CAQH & Payer Enrollment — flat fees, paid online

Every fee below is a written flat fee. Pick the line that matches your matter and pay directly — no call required. If your situation does not match a line, request a written quote and we will send one.

Medicare Enrollment

$497

PECOS enrollment or revalidation for one provider.

  • PECOS application
  • Supporting document assembly
  • Submission tracking
  • Approval letter delivered to you

Credentialing — Single Payer

$897

One provider, one commercial payer, start to approval.

  • CAQH build or clean-up
  • Payer application and roster forms
  • Follow-up until approved
  • Effective date documented

Credentialing — 5 Payers

$2,485

One provider across five payers, coordinated as one project.

  • Five payer applications
  • Single CAQH source of truth
  • Consolidated status tracker
  • Re-credentialing calendar

Above 20 enrollments we review total volume and issue a written volume structure.

Three ways to pay

Zelle — preferred, no fee

Admin@PFConsultingFirm.com
PF Consulting Firm Corp
Memo: Last Name • Type of Matter

After you pay

What happens next

Credentialing, CAQH & Payer Enrollment onboarding is the same for every client, so nothing depends on who answers the phone. Each step below is confirmed to you in writing.

  1. 1

    Written confirmation and your point of contact

    Within 1 business hour

    You receive a payment receipt, a written scope confirmation listing exactly what was purchased, and the name and direct line of the specialist assigned to your file.

  2. 2

    Secure intake link

    Same business day

    A secure intake form and upload portal is emailed to you. Everything on the checklist above is requested there in one pass — no back-and-forth email chains for documents.

  3. 3

    Completeness review

    1–2 business days after intake

    We review every item you uploaded against the requirement list and send one consolidated message listing anything still missing. Your clock starts when the file is complete.

  4. 4

    Submission and tracking

    Per the timeline above

    Applications, verifications and enrollments are submitted and logged with confirmation numbers. You receive a written status update every week until the file closes.

  5. 5

    Deficiency handling and issuance

    Ongoing until issued

    Every board or payer deficiency notice is answered in writing within its response window. When the license or enrollment issues, you receive the number, effective date and the renewal calendar.

Questions during onboarding go to your assigned specialist directly — call 877-390-2041 or reply to any email in your thread.

Credentialing, CAQH & Payer Enrollment FAQ

Frequently asked questions

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