Medical Credentialing Services
Credentialing & Payer Enrollment
Get your providers
in-network. Get paid.
Every day a provider sees patients without active payer credentialing is a day of unrecoverable revenue. MedCods handles CAQH, PECOS, Medicaid, and all commercial payers — submitting in parallel to cut your timeline by 30–60 days.
60–90
Days avg. to in-network
vs 120–150 industry avg.
vs 120–150 industry avg.
$1.8M
Max revenue gap per provider
across a 120-day delay
across a 120-day delay
55–90%
Of trapped revenue recovered
from active lapse situations
from active lapse situations
Credentialing Complete
Dr. Chen — UHC Active
MedCods
Active Provider Roster
SC
Dr. Sarah Chen, MD
Internal Medicine • NPI 1234567890
Medicare ✓
UHC ✓
Aetna ✓
MR
Dr. Marcus Reid, DO
Family Practice • NPI 0987654321
Medicare ✓
BCBS — Pending
Cigna — Day 45
LP
Dr. Lena Park, NP
Psychiatry • NPI 1122334455
CAQH — Re-attest Due
Medicaid ✓
Upcoming Deadlines — Auto-Tracked
🔄 CAQH Re-Attestation — Dr. Park
7 days
🪪 DEA Renewal — Dr. Chen
89 days
🔄 PECOS Revalidation — Dr. Reid
142 days
The Revenue Gap
Every uncredentialed day is
revenue that vanishes
A newly hired provider who isn’t credentialed cannot bill insurance. That’s it. Every day they see patients while enrollment sits in a payer’s queue is a day of unrecoverable revenue — $1,000 to $5,000 per provider per day for most specialties, and up to $15,000 per day for high-billing specialists.
Across a typical 120-day credentialing cycle, that’s $120,000 to $1.8 million in revenue your practice budgeted, expected, and never collected. And that’s just new provider onboarding. The hidden problem is worse.
61% of practices have an active credentialing lapse right now
A missed CAQH re-attestation, expired DEA, or stale taxonomy code quietly denies claims under "provider not credentialed" reason codes — and 78% of these lapses go undetected for 60+ days. The downstream cost: $18,000 to $95,000 per affected provider per year.
Revenue Impact Calculator
A 120-day credentialing delay for one physician
Revenue recovered per provider
With MedCods vs. sequential enrollment
$75K–$150K
Based on MGMA 2024 benchmarks. Actual impact varies by specialty and payer mix.
Our Process
Four stages. One credentialing team.
Zero dropped deadlines.
Most credentialing services submit applications and wait. MedCods submits in parallel, follows up every 7–10 days, and monitors every deadline so your team doesn’t have to.
1
Document Intake & CAQH Build
Within 48 hours, we collect every required document and build or fully audit your CAQH ProView profile. Field-level accuracy here accelerates every downstream payer timeline.
48-hr kickoff
2
Parallel Payer Submission
Every payer — Medicare, Medicaid, BCBS, UHC, Aetna, Cigna, Humana, and regional plans — submitted simultaneously on day one. Their clocks run concurrently, not consecutively.
Saves 30–60 days
3
Active Follow-Up & PSV
Our specialists call every payer every 7–10 days, correct documentation requests within 24 hours, and run primary source verification automatically — completing in hours, not days.
Weekly payer calls
4
Ongoing Deadline Management
CAQH re-attestation (120 days), federal directory verification (90 days), PECOS revalidation (5 years), commercial re-credentialing (3 years) — all tracked automatically with tiered reminders.
Zero silent lapses
Why parallel submission changes everything
Sequential credentialing stacks payer timelines end-to-end. MedCods runs them simultaneously.
❌ Sequential Enrollment (Industry Standard)
Total timeline (cumulative)
255–425 days
✓ MedCods Parallel Submission
Total timeline (slowest payer wins)
60–90 days
Services Covered
End-to-end credentialing — every
payer, every deadline
Medicare PECOS
Medicaid
BCBS
UHC
Aetna
Cigna
Humana
CAQH ProView
120-day re-attestation
Taxonomy codes
3-yr commercial
5-yr PECOS
90-day directory
Hospital privileging
ASC enrollment
Reappointment
Reinstatement
Retroactive billing
A/R recovery
Medical license
DEA registration
Malpractice
Board certs
Multi-state
Telehealth
State Medicaid
Mental health
DME
OB/GYN
Behavioral health
Contract review
Rate benchmarking
Negotiation support
Why MedCods
MedCods vs. in-house
credentialing
CAPABILITY
- Payer submission approach
- Average timeline to in-network
- CAQH re-attestation management
- Lapse detection & recovery
- Payer follow-up cadence
- Primary source verification speed
- Multi-state telehealth credentialing
- Retroactive A/R recovery on lapses
- Integration with billing & A/R
Typical In-House / Single-Service Vendor
- Sequential — one payer at a time
- 120–150 days
- Manual — often missed
- Discovered only after denied claims
- Ad hoc or monthly
- Manual outreach — days to weeks
- Requires separate vendors per state
- Not offered
- Separate system — manual handoff
MedCods Credentialing
- Parallel — all payers simultaneously, day one
- 60–90 days (saves 30–60 days per provider)
- Automated — 90/30/7-day reminders, handled
- Proactive monitoring — lapses caught before denial
- Every 7–10 days — per application, per payer
- Automated platform — completes in hours
- All states managed in parallel, single team
- Full recovery workflow — 55–90% of trapped revenue
- Native — credentialing status flows to claims automatically
Measured Results
What MedCods clients measure within the first year
Figures are client-reported averages from practices that replaced sequential enrollment and manual lapse monitoring with MedCods Credentialing Services.
60–90d
Average timeline to full in-network status — vs. 120–150 days with sequential enrollment
$308k
Average recovered first-year revenue per physician from timeline acceleration alone
10–20hrs
Weekly staff hours reclaimed from manual payer follow-up, CAQH management, and deadline tracking
55–90%
Of trapped revenue recovered for practices engaged in active lapse reinstatement
Why parallel submission changes everything
Sequential credentialing stacks payer timelines end-to-end. MedCods runs them simultaneously.
“We hired three NPs in Q1 and our previous credentialing vendor had them waiting 5 months before any were billable. We switched to MedCods after that experience. Our next group of four providers were all credentialed and seeing patients within 78 days. The difference was immediate and the revenue impact was real — we estimated we recovered $420,000 in first-year collections we would have otherwise lost.”
HIPAA Compliant
SOC 2 Type II Audited
AAPC Certified Specialists
BAA Included
AES-256 Encrypted
Why MedCods
The right fit for practices where
growth is the priority
Credentialing delays compound with every provider you add, every state you enter, and every year you don’t fix a lapse. MedCods Credentialing Services are structured to solve specific, high-cost situations — not to be a generic solution for any practice.
Here’s where the ROI is most immediate:
Why MedCods
The right fit for practices where growth is the priority
Credentialing delays compound with every provider you add, every state you enter, and every year you don’t fix a lapse. MedCods Credentialing Services are structured to solve specific, high-cost situations — not to be a generic solution for any practice.
Here’s where the ROI is most immediate:
Included in Professional & Enterprise Plans
Full Credentialing Suite
- Initial payer enrollment — all payers, parallel
- CAQH ProView build, audit & re-attestation
- Medicare PECOS & state Medicaid enrollment
- Proactive mAutomated deadline tracking & alertsonitoring — lapses caught before denial
- Re-credentialing & revalidation management
- License, DEA & malpractice expiration monitoring
Standalone or Add-On
Lapse Recovery & A/R Reinstatement
- Active lapse identification across all payers
- Reinstatement application handling
- Retroactive billing within timely-filing windows
- 55–90% of trapped revenue typically recovered
Free Credentialing Audit — No Obligation
We'll identify every active lapse, upcoming deadline, and enrollment gap across your current provider roster — and show you exactly what each one costs if left unaddressed.