Physician Credentialing
Here is the mistake that costs physicians the most time: treating credentialing, hospital privileging and payer enrollment as one task. They are three separate jobs, run by three different bodies, and doing them out of order is why a doctor can be fully licensed and still unable to bill or operate. Physician credentialing services exist to run all three in the right sequence so you end up verified, privileged where you need to be, and in network. We do that work for individual physicians, new hires and groups, the same discipline behind the medical credentialing services we run across every provider type.
Credentialing, privileging and enrollment are three different jobs
Most delays trace back to blurring these together, so let's separate them.
A physician can clear one and still be stuck on the next. We track all three at once so nothing waits on a step nobody started.
What we verify for a physician
Credentialing rests on primary source verification, which means we confirm each credential directly with the body that issued it, not with a copy you send us. For a physician that file usually includes:
Miss one of these and the file stalls, often without a clear reason from the payer or the committee. We build the full stack first, then keep it current.
Board certification: ABMS and AOA
Board certification is verified, not assumed. MDs are typically certified through a member board of the American Board of Medical Specialties, the ABMS. DOs are typically certified through the American Osteopathic Association, the AOA, though many DOs also hold ABMS certification. We verify whichever boards apply to you, and we treat MDs and DOs the same way. The degree differs; the credentialing rigor does not.
International medical graduates and ECFMG
If you trained at a medical school outside the United States or Canada, your file runs through one more checkpoint. ECFMG, the Educational Commission for Foreign Medical Graduates, certifies that an international medical graduate has met the standard required to enter US graduate medical education, which includes verification of your medical education credentials and passing the required exams. Credentialing bodies and payers want that ECFMG status confirmed. We know to pull it and where it slots into the file, so an IMG application does not bounce for a missing piece nobody told you about.
Enrolling a physician with Medicare, Medicaid and commercial payers
Verifying you is only half of it. Getting paid means enrolling you with every payer you want to bill, and each family works differently.
Group or solo changes the shape of this. A solo physician bills under an NPI Type 1. A group needs an NPI Type 2 for the entity, with each physician's NPI Type 1 linked to it, and credentialing runs under the group's tax ID. When a physician leaves, the group's enrollment does not leave with them. We handle both, and the wider engine behind it is our provider credentialing service.
Send us your specialty, your states and your target payers, and we will map your path.
Hospital privileging tie in
Once you are credentialed, privileging is the facility's call. We assemble and submit the application, coordinate with the medical staff office, and keep the verified file moving so the privileging committee has what it needs. The mechanics of that sit on our hospital privileging page, and we run it in step with your payer enrollment so you are not waiting on one to start the other.
New physicians and locum onboarding
Timing is the lever for new hires. Credentialing should start the moment a physician signs, not on the start date, because the clock runs in months, not weeks. Start late and a fully qualified doctor sits idle, unable to bill, while the practice carries the cost. For locum physicians the file is the same set of credentials; the difference is pace and the number of facilities or payers in play. We build the file once and reuse the verified pieces across every application.
Timelines
Timelines depend on the payer and the committee, not on how fast you sign. Industry typical ranges run about 90 to 120 days for credentialing and commercial enrollment, and roughly 30 to 90 days for Medicare through PECOS, with Medicaid varying by state. A complete file moves toward the faster end; one missing document can stretch it for months. Any timeline we commit to, we put in writing. company specific turnaround commitment
What we handle, what you supply
We own the maze. You hand us your documents, your signatures where a form needs them, and the states and payers you care about. We run primary source verification, register and link your NPIs, build and attest CAQH, confirm your board status, submit every payer application, support privileging and confirm your effective dates.
specific proof points — physicians credentialed, years in business, success rate
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