Credentialing & Enrollment

Medical Credentialing & Enrollment Services You Can Trust

Get Fast Access to Insurance Networks Without the Hassle

At Prime Edge Medical Billing, we make sure your practice gets in-network and fully credentialed while you focus on patient care. Our streamlined credentialing services help you join top insurers—including Medicare, Aetna, UnitedHealthcare, and 200+ commercial networks in record time. Say goodbye to administrative delays and secure the reimbursements you deserve.

Why Credentialing Can Be Complicated

Even well-organized practices face credentialing hurdles. The most common challenges include:

Incomplete or Expired Documentation

Missing signatures, expired licenses, or misplaced documents can cause 30+ day delays or outright denials.

Insurance Backlogs

Some payers take 6–12 months to process applications, leaving your practice in limbo.

Lost or Rejected Applications

Applications can get "lost," denied for unclear reasons, or ignored entirely.

Licensing Delays

Slow state boards can result in $10k+ per month in lost reimbursements.

Our Solutions

Document Management Made Easy

Prime Edge tracks every file, sends renewal reminders 90 days ahead, and ensures every submission is accurate and complete.

Direct Payer Access

We bypass generic portals, escalate stalled applications, and align submissions with state regulations to avoid compliance issues.

Rapid Follow-Up & Denial Resolution

Every submission is trackable, denials are clarified immediately, and re-submissions happen within 24 hours.

State Licensing Optimization

We submit applications during optimal times, follow up daily, and ensure licenses are approved without delays.

Protect Your Practice

Our compliance system prevents fines up to $50k, safeguarding both your revenue and your reputation.

Secure My Practice Today

Comprehensive Credentialing Services Across All 50 States

Prime Edge Medical Billing offers a full range of credentialing and enrollment solutions:

Payer Enrollment & Contracting

Secure contracts with private insurers, Medicare, and Medicaid, maximizing reimbursement.

CAQH Profile Management

Automated updates, attestations, and audit-ready profiles 24/7.

Medicare/Medicaid Enrollment

Fast-track approvals, bypassing months of delays.

Credentialing Revalidation

Stay ahead of renewals with automatic tracking and filings.

Hospital Privileging & Affiliation

Get credentialed at hospitals and ASCs without chasing signatures.

DEA & State License Renewals

Timely renewals with compliance checks.

NPI Registration & Management

Secure and manage your National Provider Identifier across all systems.

Insurance Panel Expansion

Add payers quickly without long wait times.

Credentialing Audits & Gap Analysis

Identify hidden risks before they impact your practice.

Locum Tenens & Temporary Credentialing

Quick approvals for staffing surges.

Denial Resolution Support

Fix credentialing-related claim denials and boost revenue.

Ongoing Compliance Monitoring

Stay audit-ready with OIG, SAM, and sanction checks.

How We Streamline Credentialing for Providers

Prime Edge Medical Billing has helped 200+ healthcare providers get credentialed efficiently:

1

Provider Documentation Collection

Licenses, DEA certifications, CVs, and malpractice insurance collected within 48 hours.

2

Primary Source Verification (PSV)

Verification of all credentials with issuing boards within 72 hours.

3

CAQH & PECOS Enrollment

Error-free applications with 98% faster approvals for commercial payers and Medicare.

4

Insurance Panel Credentialing

Submission to 250+ payers, negotiation of contract terms, and 70% faster approvals.

5

Follow-Up With Payers

Daily calls and emails until approval, reducing delays by 80%.

6

Contract Negotiation Services

Fee schedule audits, 12–22% higher reimbursement advocacy, and contract alignment with specialty value.

7

Continuous Monitoring & Recredentialing

Automatic tracking of expiring licenses and payer updates to ensure your practice is always compliant.

Why Prime Edge Outperforms Traditional Credentialing

Process
Industry Average
Prime Edge Advantage
Government Program Enrollment (Medicare, Medicaid)
3–6 months
45 days with 98% first-pass success
Commercial Payer Credentialing
2–4 months
30 days with 98% first-pass success
Compliance Checks
Manual, complex
Pre-audited for CMS and payer standards
Application Errors
Frequent
AI-assisted, error-free submissions
Reimbursement Negotiation
Fixed or minimal
12–22% higher rates advocated
Approval Rate
75–85%
98% first-pass success guaranteed

With Prime Edge Medical Billing, credentialing and payer enrollment aren't just administrative tasks they're growth engines. Let us secure your place in every network that matters and maximize your practice revenue.

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