Our Provider Credentialing & Payer Enrollment Support services are designed to eliminate administrative bottlenecks, accelerate reimbursements, and position your providers for success from day one. We manage every aspect of the process—from initial application to ongoing maintenance—ensuring accuracy, transparency, and compliance at every step.

Incomplete or delayed enrollment can result in costly reimbursement gaps and lost revenue. At Physician Revenue 360, we take a proactive, hands-on approach to streamline payer interactions and maintain credentialing integrity across your organization. 

End-to-End Credentialing Lifecycle Management

We manage credentialing from initial application through ongoing maintenance and renewals.
Our process includes:

• Verifying provider data and documentation
• Maintaining CAQH and PECOS profiles
• Submitting to commercial and government payers
• Tracking application status and follow-ups
• Managing revalidations, expirations, and updates

You’ll always know where each provider stands in the enrollment process.

Payer Enrollment Support That Accelerates Reimbursement

Payer timelines and requirements vary widely. Our specialists use payer-specific playbooks to shorten approval times and minimize rejections.

You’ll benefit from:

• Automated payer portal and reminder systems
• Centralized enrollment tracking dashboard
• Escalation protocols for delays
• Direct liaison with payer credentialing teams

Credentialing Audit & Compliance Accuracy

We audit every record before submission to ensure compliance, reduce rework, and avoid billing delays or clawbacks.

Each audit includes:

• Primary source verification checks
• Monitoring of licenses, DEA, malpractice, and CAQH expirations
• State compliance validation
• Pre-submission checklist and documentation control

Credentialing Maintenance & Renewal Tracking

We don’t stop at approval. Our maintenance service tracks renewals, updates CAQH profiles, and manages licenses and certifications—preventing lapses and ensuring continuous payer participation.

Measurable Outcomes You Can Expect

Organizations using PR360’s Credentialing & Enrollment services typically achieve:

• 50–70% faster payer approvals
• Zero missed renewals or expirations
• Consistent reimbursement activation timelines
• Centralized tracking for all provider enrollments

Related Services

• Denials & A/R Recovery — protect revenue while enrollments complete.
• End-to-End RCM Transformation — standardize edits, worklists, and QA.
• Vendor Oversight & Optimization — align partners to financial KPIs.
• Revenue Cycle Health Check — validate payer readiness and process gaps.