Articles & Resources
Plain-language guides on credentialing, payer enrollment, CAQH, and Medicare — from the team that does the work.
How Long Does Provider Enrollment Take?
Most commercial payer enrollments take 60–120 days. Medicare runs 90–180 days. The timeline depends on the payer, your specialty, your CAQH profile, and whether your application is complete when you submit it.
Read article →Can You Bill Insurance While Credentialing Is Pending?
In most cases you can't bill a payer as in-network until credentialing and contracting are done — and retroactive billing is limited. Here's what determines whether any of that waiting-period revenue is recoverable.
Read article →Credentialing Service vs. Credentialing Software: Which Do You Need?
Credentialing software is a tool your staff runs; a credentialing service is a team that does the work for you. For most small and mid-size practices, the deciding factor is who's actually going to do the work.
Read article →Credentialing vs. Enrollment: What's the Difference?
Credentialing verifies who you are and what you're qualified to do; enrollment sets up your ability to bill a payer. They're often used interchangeably, but they're two distinct steps — and you need both.
Read article →What Happens If Your Credentials Lapse?
A lapsed credential or missed revalidation can freeze your payer file and turn claims into denials — and fixing it means starting a months-long process over. Here's how lapses happen and how to prevent them.
Read article →Value-Based Medicine and Its Impact on Credentialing & Contracting
Value-based care ties reimbursement to outcomes instead of volume — and that changes what payers look for in credentialing and how contracts are structured.
Read article →5 Keys to Selecting the Right Enrollment & Credentialing Partner
Picking the right enrollment and credentialing partner comes down to five things: real experience, comprehensive scope, flexibility, clear communication, and responsive support.
Read article →Provider Enrollment and Credentialing Services: A Complete Overview
Provider enrollment establishes your billing relationship with payers; credentialing verifies your qualifications. Here's what each covers and how a service handles both.
Read article →The Importance of Credentialing Services for Medical Practices
A dedicated credentialing service takes a complex, compliance-heavy process off your staff's plate — protecting revenue, keeping providers compliant, and freeing your team for patient care.
Read article →The Pros and Cons of Outsourcing Medical Credentialing
Outsourcing credentialing can cut administrative burden and cost while adding expertise — but it comes with trade-offs around control, communication, and data security. Here's how to weigh them.
Read article →How to Choose the Right Credentialing Service for Your Practice
Choosing a credentialing service comes down to five factors — experience and reputation, technology and process, cost, turnaround, and support. Here's how to weigh each.
Read article →Challenges of the Insurance Enrollment Process
Insurance enrollment stalls in three predictable places: getting through to the payer, understanding the contract you're offered, and outlasting a slow credentialing queue. Here's how to handle each.
Read article →Payer Enrollment First Steps: 5 Tips Before You Start
The insurance enrollment process is slow and unforgiving of shortcuts. Get these five things in place first — entity and banking, location, CAQH, malpractice, and contact details — and it moves far more smoothly.
Read article →TennCare & MedCost Now Using CAQH
TennCare and MedCost have adopted CAQH for credentialing and recredentialing — a welcome step, and part of a slow but steady move by more plans toward the shared CAQH database.
Read article →Provider Enrollment & Credentialing Specialist Positions
Our provider enrollment and credentialing team is growing, and we're often looking for enrollment coordinators and account managers. Experience helps — attitude and work ethic matter more.
Read article →How Credentialing & Insurance Enrollment Can Put You Out of Business
Credentialing sits at the starting gate of the reimbursement race. Get it wrong and the damage compounds — frozen claims, denial spikes, and a new hire who can't bill. Here's how it happens.
Read article →Medicare Non-Par vs. Opting Out: Don't Be Deceived
Becoming a non-participating Medicare provider is not the same as opting out. You still face audits, EHR rules, and limits on what you can charge — here's what non-par really means.
Read article →The Credentialing and Contracting Process Explained
The credentialing and contracting process has two distinct steps: credentialing verifies your qualifications (with CAQH feeding the data), then contracting sets how and how much a payer pays you. One doesn't work without the other.
Read article →Does Medicare Use CAQH?
No, Medicare doesn't use CAQH — it uses PECOS. CAQH is a commercial-payer credentialing database, though you can still use the information stored there to help complete Medicare applications.
Read article →CAQH Credentialing Made Easy
CAQH ProView is the shared profile commercial payers pull from during credentialing — and every provider needs one. Here's how the process works and how to keep it from stalling your enrollment.
Read article →Have a question these don't answer?
Talk to an enrollment specialist — we'll give you a straight answer.
Provider Enrollment Services is a credentialing and payer-enrollment service; approval decisions and timelines are determined by the payers and CMS, not PES.