Revenue Cycle Service

Commercial Payer Enrollment & Credentialing

Comprehensive commercial payer enrollment services for all major insurance carriers. Get in-network with Aetna, BCBS, Cigna, Humana, UHC, and regional plans to maximize your patient base and revenue.

2500+ Commercial Enrollments

50+ Payers Covered

45-90 Days Average

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All Major Carriers

Complete Commercial Enrollment

Aetna, BCBS, Cigna, Humana, UHC, and regional plan credentialing

Our Process

Commercial Enrollment Made Simple

Our streamlined 3-step process gets you in-network with commercial payers efficiently.

CAQH Profile Preparation

We ensure your CAQH ProView profile is complete, attested, and optimized for commercial payer credentialing.

Multi-Payer Application Submission

We prepare and submit credentialing applications to all selected commercial payers simultaneously.

Follow-Up & Contracting

We track applications, respond to payer requests, and assist with contract review and signature.

Payers We Cover

Major Commercial Payers

We enroll providers with all major national and regional commercial insurance carriers.

Blue Cross Blue Shield

All 36 BCBS plans and BlueCard program

UnitedHealthcare

Commercial, Oxford, and UMR plans

Aetna

CVS Health commercial plans

Cigna

Cigna commercial and Cigna + Oscar plans

Humana

Humana commercial plans

Anthem

14-state Anthem BCBS plans

Kaiser Permanente

Regional HMO and PPO plans

Centene/Ambetter

Marketplace and commercial plans

Molina Healthcare

Commercial and Marketplace plans

Self-Funded Plans

ASO and TPA-managed employer plans

Regional Payers

State and regional commercial carriers

Marketplace Plans

ACA Exchange individual and family plans

Core Requirements

Commercial Payer Enrollment Essentials

We ensure all commercial payer enrollment requirements are met with precision.

CAQH Attestation

Current CAQH profile with recent attestation (within 120 days)

State Medical License

Active, unrestricted license in practicing state

DEA Registration

Valid DEA certificate for controlled substances

Board Certification

ABMS or AOA board certification status

Malpractice Insurance

Minimum coverage per payer requirements

Work History

Complete 5-year work history with gap explanations

W-9 Form

Current IRS W-9 for tax identification

Background Screening

OIG, SAM, and NPDB clearances

Plan Types

All Commercial Plan Types

We enroll providers in all types of commercial insurance plans.

PPO Plans

Preferred Provider Organization networks

HMO Plans

Health Maintenance Organization networks

EPO Plans

Exclusive Provider Organization networks

POS Plans

Point of Service plan networks

Self-Funded/ASO

Employer self-funded plan networks

High-Performance Networks

Tiered and narrow network plans

Multi-State Plans

National and multi-region networks

Student Health Plans

College and university commercial plans

Why Choose Us

Commercial Enrollment Excellence

We understand the complexities of commercial payer credentialing.

Multi-Payer Coordination

Simultaneous enrollment with multiple commercial payers to get you in-network faster.

Error-Free Applications

Complete and accurate applications that minimize processing delays and rejections.

Provider Relations Liaison

Direct communication with payer provider relations to resolve issues and expedite approvals.

Recredentialing Management

Ongoing monitoring and management of 3-year commercial recredentialing cycles.

FAQ

Commercial Payer Enrollment Questions Answered

Clear answers to common questions about commercial payer credentialing.

How long does commercial payer enrollment take?

Commercial enrollment typically takes 45-90 days from application submission. Some payers offer expedited processing for certain specialties.

Do I need separate enrollment for each commercial payer?

Yes, each commercial payer requires separate credentialing. We manage simultaneous applications to get you in-network efficiently.

Does every payer require CAQH?

Most major commercial payers require a current, attested CAQH profile. Some may have additional application requirements.

What is the difference between PPO and HMO credentialing?

Credentialing requirements are similar, but HMO networks may require additional documentation and have more restrictive participation criteria.

Can I join a payer's network if they're closed to new providers?

Some payers have closed panels. We can advise on waitlist processes and alternative network options for your specialty and location.

What is recredentialing for commercial payers?

Commercial payers require recredentialing every 3 years. We track your cycles and manage complete recredentialing for all payers.

Do commercial payers require site visits?

Site visits may be required for certain specialties or high-volume practices. We help prepare for any required inspections.

Can you help with contract negotiation?

We can review commercial payer contracts and assist with fee schedule analysis. Significant negotiation may require specialized contracting services.

What are self-funded plans?

Self-funded (ASO) plans are employer-sponsored plans where the employer pays claims directly. Enrollment is often managed through TPAs or payer networks.

Can I enroll in Marketplace plans separately?

Yes, ACA Marketplace plans often require separate credentialing from standard commercial plans. We manage both simultaneously.

Ready to Maximize Your Commercial Payer Coverage?

Let our commercial enrollment experts get you in-network with all major payers and expand your patient base and revenue.

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