Provider credentialing and payer enrollment without the paperwork backlog
A new provider who can't bill is a cost with no revenue. ClaimEdgeSolutions manages initial credentialing, payer enrollment, CAQH upkeep and re-credentialing so your providers are in-network and billing as early as possible.
Common problems we fix
If any of these are happening in your practice, revenue is slipping away every week.
- New providers seeing patients they can't bill for
- Expired CAQH attestations that silently stall enrollment
- Missed re-credentialing dates that drop providers out of network
- Months of follow-up calls with payer enrollment departments
How ClaimEdgeSolutions handles credentialing & enrollment
Initial credentialing
Applications to commercial payers, Medicare (PECOS) and Medicaid, with every document gathered and checked.
CAQH ProView management
Profiles created, updated and re-attested every 120 days.
NPI, PTAN & taxonomy
Type 1 and Type 2 NPIs, taxonomy codes and Medicare PTAN set up correctly.
Re-credentialing
Expiry tracking with renewals started well ahead of deadlines.
Contract review
Fee schedule and contract terms reviewed before you sign.
Credentialing grid
A live tracker showing each provider, payer, status and effective date.
Specialists who own your credentialing & enrollment
You get named people who learn your providers, payers and workflows, not a rotating queue. Every open item has an owner and a deadline.
- Initial credentialing
- CAQH ProView management
- NPI, PTAN & taxonomy
The metrics we report on
Your monthly report tracks these numbers for this service, alongside your overall revenue cycle KPIs.
Application to effective date
Per provider
Always current
From audit to results in four steps
Free revenue audit
We review your A/R aging, denial history, payer mix and coding patterns, then show you what is recoverable.
Onboarding
BAA signed, secure system access set up, workflows mapped and your dedicated team assigned.
Daily operations
Claims, payments, denials, A/R and patient billing are worked every business day.
Monthly review
A KPI report and a call with your account manager covering results and next steps.
Often paired with Credentialing & Enrollment
Medical Billing & Coding
Certified coders and billers who turn every encounter into a clean, compliant claim.
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Revenue Cycle Management
End-to-end RCM from patient scheduling to the final zero balance.
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Denial Management
Work every denial, win the appeal, and fix the root cause.
Explore serviceAvailable for every specialty, including
Frequently asked questions
Straight answers about how ClaimEdgeSolutions works with your practice.
Ask us anything01How long does credentialing take?
Timelines are set by payers and typically range from 60 to 150 days. We submit complete applications quickly and follow up on a fixed schedule to keep that window as short as possible.
02Do you handle group and individual enrollment?
Yes, for solo providers, group practices, facilities and new practice start-ups.
03Can you help with hospital privileges?
We prepare and track privileging applications alongside payer enrollment.
04What do you need to start?
Provider CV, licenses, DEA, board certification, malpractice certificate and NPI details. We send a simple checklist.
05Do you sign a Business Associate Agreement?
Yes. A BAA is signed with every client before we access any protected health information.
See where your revenue is leaking
Get a free, no-obligation revenue audit. We review your A/R, denials and coding patterns and show you exactly what is recoverable.