Medicare credentialing is the process of enrolling your practice with the federal Medicare program. Without Medicare enrollment, you cannot bill or receive reimbursement for Medicare patients — which can be a significant portion of your patient base. Our service handles CMS-855 forms, PECOS registration, and all follow-ups.

Medicare enrollment typically takes 30-90 days depending on provider type and application completeness. CMS-855I (individual) is usually faster than CMS-855A (facility). We review all applications before submission to prevent delays caused by errors or missing information.

CMS-855A is for facilities and hospitals. CMS-855B is for clinics and group practices. CMS-855I is for individual providers. CMS-855S is for DMEPOS suppliers. Each form has different requirements and processing times. We help you determine which form(s) you need and complete them accurately.

PECOS (Provider Enrollment, Chain, and Ownership System) is Medicare's online enrollment system. All Medicare providers must enroll through PECOS or submit paper CMS-855 forms. We handle both PECOS registration and ongoing maintenance for you.

Medicare requires all providers to revalidate their enrollment every 3-5 years. During revalidation, you must update your CMS-855 information and confirm your practice details. Missing a revalidation deadline can result in Medicare termination. We track all revalidation dates and handle the process for you.

Yes. While Original Medicare enrollment is through CMS, Medicare Advantage plans (like Aetna Medicare, UHC Medicare, Humana) require separate credentialing. We help you enroll in both Original Medicare and individual MA plans to maximize your Medicare patient access.

In many cases, yes. Medicare allows retroactive billing once your enrollment is approved — typically back to your application date or the date you began seeing Medicare patients (up to 30 days prior). We advise you on the timing so you don't lose revenue during the waiting period.