Medical Credentialing Services & Provider Enrollment
Credentialing is more than filling out forms. Each application has to match licensing data exactly.
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Proven Practice Excellence & Financial Impact
Credentialing is more than filling out forms. Each application has to match licensing data exactly.
Medical Credentialing Services & Provider Enrollment handle the full process of a physician's insurance enrollment setup from start to finish. This includes gathering and verifying licenses, certifications, and training records.
- 98% First-Pass Clean Claims: Multi-tiered pre-submission scrubbing eliminates payer rejections before delivery.
- AAPC & AHIMA Certified Coders: Specialty-fluent coding safeguards clinical documentation and audit compliance.
- Aged AR Resolution: Relentless appeals and follow-up on claims aged 60, 90, and 120+ days recapture lost revenue.
Key Performance Indicators
Our track record across healthcare providers nationwide speaks for itself:
End-to-End Practice Management Solutions
Every element of our clinical billing service is crafted to eliminate delays, protect cash flow, and ensure HIPAA compliance.
Initial Payer Enrollment
Fast-track provider applications and contract negotiations with commercial carriers, Medicare, and Medicaid with complete CAQH profile management.
Hospital Privileging Support
Structured credentialing packets and primary source verification expedite clinical hospital privileging and ambulatory surgery center appointments.
Re-Credentialing Tracking
Proactive expiration monitoring alerts our team months ahead of license, DEA, malpractice, and board certification renewals to prevent enrollment lapses.
Medicare & Medicaid Setup
Accurate CMS-855 forms filing and PECOS updates streamline national and state government healthcare program approvals without administrative delays.
CAQH Profile Maintenance
Continuous CAQH attestations and document uploads keep provider profiles fully compliant and ready for payer network directory validation.
Dedicated Enrollment Lead
Your assigned credentialing coordinator tracks application progress daily and provides weekly status updates until all payer contracts are finalized.
In-House Billing vs. NovaMedex Partnership
Compare the costs, risks, and performance between conventional in-house billing and our outsourced billing model.
In-House Billing
- High staffing costs: salaries, health insurance, 401(k), and paid time off.
- Turnover disruptions: claims stall when billing staff leaves or takes sick leave.
- Expensive software licensing, clearinghouse fees, and continuous IT support.
- High denial rates (10-18%) due to lack of specialty-certified coding expertise.
- Slow aged AR recovery: old unpaid claims often written off as bad debt.
With NovaMedex
- Low, all-inclusive 2.49% fee based entirely on collections. You pay only when you get paid.
- Uninterrupted continuity: team of certified backup billers eliminates staffing risk.
- Free cloud EHR, PMS, and clearinghouse connection included at zero cost.
- 98% first-pass clean claim acceptance with certified AAPC medical coders.
- Dedicated AR recovery team relentlessly appeals and recovers aged claims.
Frequently Asked Questions
Common questions healthcare practices ask when partnering with NovaMedex.
Our onboarding team can fully integrate with your practice in as few as 5 to 7 business days. We coordinate EDI enrollments, software setup, and staff workflow orientation smoothly without disrupting your daily patient care.
No. While we provide free cloud EHR and PMS software, our certified billers and coders are experienced across all major healthcare EHRs including Epic, Cerner, eClinicalWorks, Athenahealth, Kareo, NextGen, and AdvancedMD.
Our transparent medical billing fee starts at just 2.49% of monthly collections. We do not charge upfront onboarding fees or software license fees. We only earn when you receive reimbursement.
Every rejected or denied claim is reviewed within 24 to 48 hours by our specialized denial management team. We perform root-cause resolution, correct coding or demographic issues, and submit formal payer appeals immediately.
Yes. All NovaMedex operations, cloud infrastructure, and data handling protocols adhere strictly to HIPAA and HITECH security standards with full 256-bit encryption and signed Business Associate Agreements (BAAs).
Ready to Accelerate Your Practice Collections & Eliminate Denials?
Connect with a senior NovaMedex revenue cycle consultant for a free, comprehensive billing audit and revenue projection.