Seamless Enrollment
Provider Credentialing & Enrollment
Credentialing is the process of enrolling a provider with insurance networks so their services can be billed. Until it completes, a provider generates cost but no billable revenue. Vizora manages applications, primary source verification, CAQH maintenance and re-credentialing so revenue starts as early as possible.
What’s included
- Application management — Complete application preparation and submission to each target network.
- Primary source verification — Licenses, education, board certification and work history verified and documented.
- CAQH maintenance — Profiles kept current and re-attested on schedule so enrollment is never blocked.
- Payer follow-up — Applications actively tracked with each payer rather than submitted and awaited.
- Re-credentialing — Renewal deadlines tracked and processed ahead of expiration.
- Status reporting — Clear visibility into where every provider stands with every payer.
The problem
Where credentialing goes wrong
New providers unable to bill for months after their start date
Applications rejected for incomplete or inconsistent information
CAQH profiles lapsing and silently blocking enrollment
Re-credentialing deadlines missed, causing network termination
No visibility into where each application actually stands
Revenue lost permanently for services rendered pre-enrollment
How it works
Our credentialing process
Application (weeks 1–2)
Document collection, CAQH profile setup and initial submission to target payers.
Verification (weeks 3–6)
Primary source verification of licensure, education, board certification and work history.
Committee review (weeks 7–10)
Payer credentialing committee review, with active follow-up on anything outstanding.
Enrollment (weeks 11–12)
Network addition, provider ID issuance and configuration in your billing system.
Outcomes
What changes for your practice
We baseline these during the free audit so improvement is measured against your actual starting point, not an industry average.
Get your free audit- Providers billing sooner after their start date
- Fewer applications rejected on technicalities
- No lapses in network participation
- CAQH kept current without internal effort
- Enrollment status visible at a glance
- Revenue protected during practice growth
Specialty coverage
Credentialing by specialty
Each specialty fails differently. These pages cover the specific codes, denial patterns and payer rules that apply.
Questions
Credentialing FAQ
Last updated August 20, 2026
Reviewed by a certified coding leadTypically 60–90 days from complete application to network approval, though it varies by payer and state. Medicare and Medicaid often run longer than commercial plans. The most common cause of delay is an incomplete initial application, which is why the preparation stage matters more than it appears.
It depends on the payer. Some permit retroactive billing to the application date once approved; many do not. This is why starting credentialing well before a provider's start date has direct revenue consequences — we begin as early as your onboarding timeline allows.
CAQH ProView is the centralized database most commercial payers pull credentialing data from. If a profile is incomplete or its attestation lapses, applications stall without the practice necessarily being notified. We maintain and re-attest profiles on schedule so this never becomes the bottleneck.
Yes. Re-credentialing typically recurs every two to three years per payer. We track every renewal deadline and process it ahead of expiration, because a lapse can mean termination from the network and an interruption in payment.
Terms used on this page
Credentialing
Credentialing is the verification of a provider's qualifications by a payer, and enrollment is the resulting contract that permits billing under that plan. The process commonly takes 90 to 180 days, and claims for services delivered before the effective date are generally not payable.
NPI
A National Provider Identifier is the 10-digit identifier required on all HIPAA standard transactions. Type 1 identifies an individual provider; Type 2 identifies an organization. Both usually appear on a claim — the rendering provider as Type 1, the billing entity as Type 2.
Still deciding how to run billing at all? Compare in-house against outsourced or read the full set of comparisons.
Find out what your denials are costing you
A free billing audit reviews your denial rate, AR aging and clean claim rate against industry benchmarks. Takes about two minutes to request. No sales pitch.
No setup fees · You pay when we collect · Pricing from 3% of net collections