Medical Credentialing Services

State-wide Provider Credentialing & Enrollment Services

Ensure your healthcare organization continues to provide the highest level of care without delays and unnecessary stress with the help of Neolytix provider credentialing services.

Neolytix Provider Credentialing Services

For Healthcare Organizations Passionate About Quality Healthcare and Streamlined Operations

Credentialing involves verifying a healthcare provider’s credentials like qualifications, experience, etc to ensure their ability to provide quality care when becoming part of insurance networks. Health insurance companies, like CMS/Medicare, Medicaid, UnitedHealthcare, Anthem, Blue Cross Blue Shield, Aetna, Cigna, Humana, etc require this process.

Thriving healthcare organizations realize that the credentialing/enrollment process and the continuous maintenance required are frustrating and resource hungry.

Neolytix offers an expedited, cost-effective credentialing solution designed to consume minimal time from healthcare organizations and medical practices and cause minimal disruption.

provider credentialing services

A Credentialing Process to Complement and
Not Complicate Your Operations

The initial credentialing process, maintenance of records, and re-credentialing are tedious and resource-hungry processes and, if not monitored closely, could cause additional delays and stress. Provider credentialing begins with the application submission and ends when you have the fully executed contract with an effective date. Many applications are given an abandoned or incomplete status due to lack of follow-up or missing contract signatures.
credentialing process flow chart
We have managed to optimize our operations over 11 years of providing credentialing services to healthcare providers nationwide. Regardless of specialization, location, and type of credentialing, our teams have experience in successfully applying and expediting any provider credentialing process.

Provider Credentialing and Payer Enrollment For Every Provider in Your Healthcare Organization

Smaller practices looking to scale or larger healthcare organizations and multi-site medical facilities will have numerous healthcare providers on their payroll, with new providers needing credentialing coming into the organization quite often. Keeping track and updating records is timeconsuming.

Neolytix’s back-end monitoring and accountability frameworks leave minimal room for error. With monitoring software keeping a perfect paper trail, AI analyzing communications for quality insurers, and supervisors meticulously monitoring every team member, you can rest assured that every type of healthcare provider that enters your healthcare organization will be credentialed as fast as possible and their information kept up to date.

The Medical Specialties Neolytix Most Frequently Helps Become In-Contract Provider

Medical credentialing services
The Medical Specialties Neolytix Most Frequently Helps to Become In-Contract Providers

Neolytix Provider Credentialing Options

Medical credentialing isn’t a once-off occurrence. It requires continuous maintenance and updating with various underlying dependencies (like licenses) that also need constant attention. Neolytix credentialing experts help medical providers and organizations avoid disruptions by providing ongoing support for credentialing and maintenance.

Medical Credentialing & Enrollment

Neolytix provides one-time provider credentialing services for private practices. This excludes maintenance and re-credentialing support and is perfect for medical providers who must get out of an administrative bottleneck situation.

  • Generate and provide a checklist of requirements
  • Accumulation of documentation
  • Submissions to selected payers
  • Follow-ups with payers and feedback to you
  • Collection from payers and delivery of documentation to you

Medical Credentialing & Enrollment + Continuous Support

Neolytix provides ongoing support, maintenance of documentation, monitoring of deadlines and researching legislative and best-practices changes.
  • Preparations and checklist generated
  • Accumulation of documentation
  • Submissions to selected payers
  • Follow-ups with payers and feedback to you
  • Collection and delivery of documentation
  • CAQH, Availity, Optum (all insurance portal) attestation and updates
  • NPI registry demographic change
  • Monitoring licensing renewal dates
  • Monitoring of recredentialing dates
  • Managing recredentialing and revalidation
  • Regular best-practice research and benchmarking

What Information is Needed for Provider Credentialing

Provider credentialing requires a comprehensive review of a healthcare provider’s qualifications, credentials, and work history to ensure that they meet the standards set by regulatory bodies, healthcare organizations, and insurance companies.

Although there might be deviations in the information requirements but typically, the following is required:

Remember that the ongoing process of provider credentialing requires redoing it every 3 to 5 years. Neolytix will keep the information up to date. They will also check licensing requirements. Licenses need to be renewed every two or three years, depending on the state.

Additionally, Neolytix will manage your CAQH profile. They will also make sure re-credentialing happens on time. This will be done without any issues that could disrupt operations or cause revenue loss.

Be Process-Ready and Prevent Disruptions

Use our comprehensive checklist to equip yourself with the necessary information and strategies to proactively overcome obstacles, ensuring a smoother and more efficient credentialing and enrollment experience.

Why Should You Outsource Provider
Credentialing To Neolytix?

After more than 11 years of providing physician credentialing services and other administrative services to healthcare organizations, practices, and physician groups nationwide, we have come to know the lay of the land pretty well.

Neolytix can save you time while reducing hiccups and headaches by handling your provider credentialing and maintenance service. Our experienced medical credentialing services teams streamline the process and ensure compliance with industry regulations. We work with a wide range of insurance companies, navigate their processes, and help you choose the best plans.

You remain in the driving seat of your cash flow by customizing our services and enjoying flexible pricing options to fit your unique needs and budget. Trust us to show you how our medical credentialing department can handle your credentialing and enrollment, giving you more time to focus on matters relating to providing excellent healthcare.

customer service

11+ Years of Experience

enrollment process


health insurance

Available to all specialties

primary source verification

Maintenance and Re-credentialing

medicare medicaid

Medicare Enrollment / Medicaid enrollment

credentialing applications

Additional Licensing Services


Listen to what our clients
have to say

Sue Robbins
Sue Robbins
Neolytix has helped so much with our outstanding A/R. They are always so very willing to help and complete the task in a timely manner.
We transitioned to Neolytix a while back, having come from a billing company we were less than thrilled about. The people here have been very responsive to our needs and requests, and adapt quickly to whatever curve balls our practice throws them. They bring a wealth of knowledge to the table, and take the attitude that our success is their success.
Sandy M
Sandy M
I was a new office manager for a private practice when I hired Neolytix for credentialing assistance. Eden has been very thorough and helpful every step of the way. insurance credentialing can be so overwhelming at times, that having this task off my plate has given me a peace of mind. I know she is handling everything. Always quick to respond to questions or concerns.
Cheryl Lambert
Cheryl Lambert
Neolytix is the most professional and hard working billing company I have ever been partners with . I call them a partner because they truly are. Neolytix makes sure what they bill is accurate. Their knowledge of physician billing is outstanding. The entire team takes control and does what is necessary to make sure you get paid.
Priti Patel
Priti Patel
I habe hired a virtual assistant through Neolytix and she is amazing. The team has trained her well so I didn't have to deal with that aspect so I can focus on running my clinic. She is fast and responsive to clinic tasks. Patients have said positive things about her as well.The team at Neolytix did well...I just wish I would have signed up sooner 😅

Frequently Asked Questions (FAQ’s)

Healthcare providers should expect a streamlined and efficient credentialing process when outsourcing to a Medical Credentialing Service Provider Company. The company should handle all aspects of credentialing, including primary source verification, accurate documentation, and timely submission of applications. They should thoroughly understand the regulatory landscape and provide ongoing support and communication. The outsourced company should provide updates on the progress of the process. The goal is to ensure that healthcare providers have a simple and seamless process for obtaining their credentials. This allows them to focus on providing quality care to patients.
Medical credentialing companies provide a range of services when healthcare providers outsource their credentialing process to them. These include primary source verification, accurate documentation, and timely submission of applications. They also monitor and maintain provider credentials, ensuring compliance with regulations and requirements. Additionally, they provide ongoing support and communication, including updates and reports on the credentialing process. The goal is to ensure that healthcare providers have a smooth and efficient credentialing process. This will allow them to focus on providing quality care to patients.
The expected duration of the provider credentialing process can vary depending on various factors, such as the complexity of the application, the number of providers being credentialed, and the responsiveness of third-party organizations involved in the process. However, on average, the provider credentialing process can take anywhere from 60 to 90 to even 120 days. It is important to note that the duration can be shortened by outsourcing to a reputable medical credentialing service provider company that can handle the process efficiently and effectively.
  1. Verify NPI Registry for correct information and taxonomy. 
  2. Check CAQH profile, ensure documentation is up-to-date and re-attested. 
  3. Confirm with insurance if group/provider is contracted with requested payor. 
  4. Fill out appropriate paperwork to get provider/group contracted. 
  5. Review all paperwork carefully before submitting the application. 
  6. Submit the application to the payor to complete the contracting process. 
  7. Follow up every 2-3 weeks to ensure timely processing  
  8. Informing providers on credentialing process approval 
  9. Facilitate contract execution between the provider and Insurance enrollment plan.  
  10. Confirm the effective date of in-network is the same or as close as possible to the initial request date.
It can vary based on your services, the people you serve, and location. When choosing insurance companies, consider their network size, plan options, reimbursement rates, and credentialing requirements. It’s generally a good idea to start with the largest insurance companies in your area, as they tend to have the largest patient networks and offer the most coverage options. However, you should also consider other factors such as their plans, repayment terms, and approval process. These additional aspects are important to take into account when making a decision. It is crucial to evaluate the plans offered by the company and determine if they align with your needs and goals. Additionally, understanding the repayment terms is essential to ensure you can comfortably meet the financial obligations. Lastly, assessing the ease of approval can save you time and effort in the application process. You can hire a specialist company like Neolytix to handle provider credentialing for you. They already have most of the information and will do the work to fill in any missing details.
Credentialing is about joining insurance panels to bill as an in-network provider for medical or insurance purposes. Primary Source Verification is the process of checking a provider’s credentials directly with the original source.
Healthcare organizations must verify the authenticity of degrees, work experience certifications, and licenses. This is necessary to prevent liability caused by providers using fraudulent methods. For instance, using fake degrees or falsifying resumes to get employment poses a significant threat to healthcare organizations. To prevent risks, healthcare organizations require doctors and providers to verify their credentials before hiring them.

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