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Virtual Medical Assistant

ENROLLMENT AND CREDENTIALING SERVICES

Why choose MedStates Medical Billing Company Services

What do we refer to as Provider enrolment in healthcare industry?

Enrolment, often referred to as Provider Enrolment and Payor Enrolment is a crucial step to ensure that physicians and other medical professionals are allowed to take part in insurance networks. In order to provide medical services to patients on account of insurance network, healthcare providers must enroll themselves with insurance network to get paid for the services offered.

The process of enrolment with health care insurance network typically involves provider credentialing to validate the pre-requisites, necessary medical qualification, affiliation with medical associations, obtained certifications and proven experience in the field of healthcare, which is usually done by the issuing authority. Moreover, the process of enrolment also includes the request to participate or join medical insurance network in addition to submission of necessary supporting documents to formally sign the contract with insurance companies.  

Healthcare provider must credential themselves with the Payer/Insurance in order to provide medical services to patients who are enrolled with Insurance/Payer’s plans. At MedStates, we provide Physicians credentialing services to meet insurance credentialing requirements including validation ensuring healthcare practitioner/provider meets the guidelines so to provide clinical services to the patients. Further, the process of doctor’s credentialing service involves the verification of physician/healthcare practitioner medical education, license validation, affiliation with healthcare associations, and certifications etc.

Since the process of Revenue Cycle Management (RCM) intends to optimize revenue and achieve the financial performance in terms of profitability and increasing revenue stream of the healthcare provider, therefore, providers’ enrollment and credentialing act as a pre-requisite to avoid delay or refusal of payments by insurance/payers and to keep the financials growing positively. If you want to find how much does provider credentialing cost, MedStates is a one-stop RCM solutions which keep you going including enrollment, credentialing, cpt coding, ICD-10, medical billing services, claims submission, denial management and appeals. Sign up now!

Doctor/Provider enrollment and credentialing services can be time consuming because of its comprehensive requirements and pre-requisites but it is necessary since non-credentialed physician can not provide medical facilities to patients. Further, the payment can be delayed or claim can be refused because of non-enrollment and credentialing. MedStates take responsibility of this whole process and keep up with the changes taking place and do regular follow-ups with the payer so delays can be avoided while ensuring that the practice cash flow is not compromised. 

MedStates amongst other top-rated medical billing companies position itself as a valuable partner in navigating the complexities of medical billing services. This not only addresses immediate needs during transitions but also supports the long-term financial health and sustainability of medical practices through professional credentialing services. Our aim is to broaden practice revenue stream for your practice in most efficient way possible. MedStates provides Provider enrollment and credentialing services to assist in:

Process of Providers Enrollment and Credentialing

Healthcare providers enrollment and credentialing are crucial processes in the medical billing industry to ensure that physician is qualified and authorized to deliver medical services. Here is an overview of the process


The entire enrollment and credentialing process in medical billing aims to protect patient payers and healthcare organizations by ensuring that only qualified and competent healthcare providers deliver healthcare services. It assists in maintaining a high standard of care and compliance with regulatory requirement. 

Benefits of MedStates Credentialing Services

With access to

24 Hour

Virtual Medical Assistant