Expert Medical Credentialing and Contracting for Faster Approvals
At RCM Insiders, we streamline the entire medical billing, credentialing, and contracting process for healthcare providers. From clean claim submission to provider enrollment, contract negotiation, and payer revalidation, our team manages every step with accuracy and compliance. This allows you to stay focused on delivering exceptional patient care while we ensure you get credentialed faster, stay contracted with payers, and receive timely, maximized reimbursements.
What We Offer
Credentialing & Provider Enrollment
We manage the full credentialing process NPI, CAQH, PECOS, Medicare, Medicaid, and commercial payers ensuring your providers are enrolled quickly and accurately.
Payer Contracting & Negotiation
We help you obtain fair contracts with insurance companies by negotiating fee schedules and improving reimbursement terms to maximize your revenue.
Compliance & Document Management
We track all required documents licenses, certifications, malpractice insurance, CAQH updates, tax forms, and renewals to make sure your provider profiles stay compliant year round. Our team proactively manages upcoming expirations to prevent disruptions in reimbursement.
Ongoing Provider Profile Maintenance
Once credentialed, your provider information must remain accurate. We continuously update payer portals, hospital systems, and credentialing databases whenever you add locations, change tax IDs, or modify provider details. This ensures uninterrupted participation with all payers.
Revalidation & Re-Credentialing Support
Every payer requires regular revalidation. We handle these cycles on your behalf submitting updated documents, responding to payer requests, and confirming approval so your provider status never lapses and your claims keep getting paid smoothly.
Enrollment Tracking & Status Follow-Ups
We actively monitor your applications across all payers, keeping you informed at every stage. Our team follows up with insurance companies to speed up processing, resolve missing information, and eliminate delays that can hold back your revenue.
Provider Enrollment:
We assist in enrolling providers with all major insurance networks and government payers (Medicare, Medicaid, etc.).
CAQH Profile Setup & Maintenance:
Our team ensures your CAQH profile is always up to date and compliant.
Recredentialing & Revalidation:
We manage renewals and updates with payers to avoid any disruption in reimbursements.
Document Management:
All credentialing documents are securely stored, organized, and accessible when you need them.