Government Payer

Medicare Credentialing & Provider Enrollment

Complete Medicare provider enrollment services including PECOS registration, revalidation, and Medicare Advantage plan credentialing. Get approved to serve millions of Medicare beneficiaries nationwide.

1800+ Medicare Providers

60-90 Days Average

99% Approval Rate

Start Medicare Enrollment Free Medicare Consultation

CMS Approved Process

Complete Medicare Enrollment

PECOS, Medicare Advantage, and Part D credentialing

Our Process

Medicare Enrollment Made Simple

Our comprehensive 3-step process navigates CMS requirements efficiently.

PECOS Registration & Document Collection

We establish your PECOS account and collect all required CMS documentation including 855 forms.

Application Submission to MAC

We prepare and submit complete Medicare enrollment applications to your Medicare Administrative Contractor.

Follow-Up & PTAN Assignment

We track applications, respond to MAC requests, and ensure successful enrollment with PTAN assignment.

Medicare Programs We Cover

All Medicare Program Types

We credential providers for all Medicare programs and plan types.

Medicare Part B

Traditional fee-for-service Medicare enrollment

Medicare Advantage (Part C)

HMO, PPO, PFFS, and SNP plans

Medicare Part D

Prescription drug plan credentialing

DME Suppliers

Durable Medical Equipment provider enrollment

Home Health & Hospice

Medicare-certified home health agencies

Facilities & ASCs

Hospitals, surgery centers, and skilled nursing

Dual Eligible (Medicare-Medicaid)

D-SNP and MMP plans

Ambulance Services

Medicare ambulance provider enrollment

CMS Requirements

Medicare Enrollment Forms & Applications

We expertly prepare all required CMS forms for your provider type.

CMS-855I

Individual physician and non-physician practitioner enrollment

CMS-855R

Reassignment of Medicare benefits to groups

CMS-855B

Clinics, group practices, and other organizations

CMS-855A

Hospitals, home health, and institutional providers

CMS-855S

DME suppliers and screening requirements

State Medical License

Active, unrestricted license in practicing state

NPI Number

National Provider Identifier registration

PECOS Account

Provider Enrollment, Chain, and Ownership System

Medicare Advantage

Major Medicare Advantage Plan Credentialing

We credential providers with all major Medicare Advantage plans nationwide.

UnitedHealthcare AARP

UHC Medicare Advantage plans

Humana Medicare

Humana Gold Plus and Choice plans

Aetna Medicare

Aetna Medicare Advantage plans

Cigna Medicare

Cigna Preferred Medicare plans

Anthem Medicare

Anthem Medicare Advantage plans

BCBS Medicare Advantage

All Blue Cross Blue Shield Medicare plans

Kaiser Permanente

Kaiser Medicare Advantage plans

Centene/WellCare

WellCare Medicare Advantage plans

Why Choose Us

Medicare Enrollment Excellence

We understand the complexities of CMS requirements and Medicare enrollment.

PECOS Expertise

Complete management of PECOS registration, updates, and ongoing maintenance.

855 Form Mastery

Error-free preparation of all CMS-855 forms to prevent application rejections.

Revalidation Management

Proactive tracking and management of Medicare's 5-year revalidation cycle.

MAC Liaison Support

Direct communication with Medicare Administrative Contractors to resolve issues.

FAQ

Medicare Credentialing Questions Answered

Clear answers to common questions about Medicare provider enrollment.

How long does Medicare enrollment take?

Medicare enrollment typically takes 60-120 days from application submission. PECOS-only enrollment may be faster. We track all timelines.

What is PECOS?

PECOS (Provider Enrollment, Chain, and Ownership System) is the online Medicare enrollment system. All Medicare providers must have a PECOS account.

What is the difference between Medicare Part B and Medicare Advantage?

Part B is traditional fee-for-service Medicare administered by CMS. Medicare Advantage (Part C) is private insurance that contracts with Medicare.

What forms do I need for Medicare enrollment?

Most individual providers need CMS-855I (individual enrollment) and CMS-855R (reassignment to group). We determine exactly what you need.

What is Medicare revalidation?

Medicare requires providers to revalidate enrollment every 5 years. We track your cycle and manage the complete revalidation process.

What is a PTAN?

PTAN (Provider Transaction Access Number) is your Medicare billing number. You receive this after successful enrollment.

What is a Medicare Administrative Contractor (MAC)?

MACs are regional contractors that process Medicare enrollment and claims. Your MAC depends on your state.

Do I need separate enrollment for Medicare Advantage plans?

Yes, each Medicare Advantage plan requires separate credentialing. We manage enrollment with all major plans.

Can non-physician providers enroll in Medicare?

Yes, NPs, PAs, therapists, and other providers can enroll. Requirements vary by provider type.

What is the OIG exclusion list?

The OIG exclusion list identifies providers barred from federal programs. We screen all providers before enrollment.

Ready to Enroll with Medicare?

Let our Medicare enrollment experts navigate CMS requirements and get you approved to serve millions of beneficiaries.

Start Medicare Enrollment Free Medicare Consultation