Credentialing & Contracting
Get In-Network Faster With Expert Credentialing and Payer Contracting
Every day your credentialing application sits unprocessed, you are losing billable revenue. A missing document, wrong CAQH attestation date, or overlooked re-credentialing deadline can delay enrollment by months.
B3CARE manages the entire credentialing lifecycle on your behalf, from initial application to re-credentialing cycles, payer follow-up, contract review, and approval handoff.
Enrollment Visibility
CAQH, PECOS, Medicaid, commercial payer applications, contract terms, and re-credentialing deadlines tracked in one workflow.
60-120
Days for many commercial payer applications
120
CAQH attestation cycle awareness
90
Days ahead for re-credentialing alerts
Credentialing Services
B3CARE manages the details that keep enrollment moving.
Credentialing is part documentation control, part payer follow-up, part contracting strategy. We organize the process so your team is not chasing portals, paperwork, and effective dates alone.
CAQH ProView management
Profile creation, completion, document upload, payer-ready data cleanup, and quarterly attestation management.
Medicare PECOS enrollment
Initial enrollment, reassignment of benefits, supporting documentation, status follow-up, and revalidation planning.
Medicaid enrollment
State-specific Medicaid enrollment workflows, required forms, provider documentation, and payer follow-up.
Commercial payer credentialing
Applications for major carriers, regional plans, and priority networks aligned to your specialty and market.
Hospital privileges coordination
Medical staff office liaison support, privilege application tracking, and missing-document coordination.
DEA and state license verification
Provider license, DEA, malpractice, board certification, education, and professional record review support.
Payer contract review
Fee schedule analysis, reimbursement term review, renewal clause checks, and payment policy evaluation.
Contract negotiation support
Identify underpayment clauses, unfavorable network restrictions, and terms that may limit long-term revenue.
Re-credentialing tracking
Automated renewal visibility and proactive alerts before credentials, attestations, or payer deadlines expire.
Mid-cycle status reporting
Biweekly application status updates, payer follow-up notes, open items, and next-step visibility.
Payer Contracting
Getting in-network matters. Getting paid fairly matters too.
Many physicians accept payer contracts at face value without realizing commercial contracts may have room for negotiation, especially for in-demand specialties or practices with meaningful patient volume.
B3CARE reviews payer contracts for underpayment clauses, narrow network restrictions, renewal provisions, and terms that could affect your long-term reimbursement.
Contract Review Focus
Fee schedule alignment against Medicare and regional benchmarks
Underpayment clauses and carve-out review
Renewal, termination, and notice period visibility
Network restriction and referral requirement review
Specialty-specific reimbursement opportunities
Credentialing effective date and billing handoff coordination
Credentialing Timeline
What to expect by payer type.
Timelines vary by payer, specialty, state, application completeness, committee schedules, and contracting requirements. B3CARE tracks each application so open items do not sit unnoticed.
Medicare (PECOS)
30-60 business days
Medicaid (State)
30-90 business days
Major Commercial (BCBS, Aetna, Cigna)
60-120 days
Regional/Local Plans
30-90 days
Hospital Medical Staff
60-180 days
Step-by-Step Process
The B3CARE credentialing lifecycle
Our process keeps provider data, payer submissions, contract review, effective dates, and re-credentialing deadlines visible from start to finish.
Provider intake
Collect provider demographics, licenses, DEA, malpractice, education, work history, NPI, Tax ID, and payer priorities.
Document review
Audit required documents and identify missing, expired, inconsistent, or payer-sensitive information before submission.
CAQH and profile setup
Create or update CAQH, complete payer-facing provider records, upload documents, and manage attestations.
Payer enrollment
Submit Medicare, Medicaid, commercial payer, and regional plan applications with tracking for each payer.
Contract review
Review contract terms, fee schedules, network participation details, reimbursement patterns, and renewal language.
Payer follow-up
Follow up proactively on pending applications, missing documents, committee review, contracting, and effective dates.
Approval handoff
Confirm effective dates, payer IDs, billing setup needs, contract details, and payer-specific claim requirements.
Ongoing tracking
Monitor re-credentialing cycles, CAQH attestations, license dates, revalidation windows, and payer renewals.
Enrollment Risks
Small credentialing misses can block months of revenue.
Expired CAQH attestation
Missing malpractice certificate
Incorrect reassignment details
Untracked payer follow-up
Missed re-credentialing deadline
Low-value contract terms
Connected Services
Credentialing connects directly to launch, billing, and claim payment.
Credentialing FAQs
Common questions about provider enrollment.
Can I see patients before credentialing is complete?+
Yes, with certain limitations. Some payers allow provisional or locum tenens billing arrangements during the credentialing period. Medicare allows retroactive billing in limited circumstances. B3CARE will advise you on what is allowable under each payer's policies.
What is CAQH and why is it important for credentialing?+
CAQH ProView is a centralized database most major commercial payers use to collect and verify provider information. Keeping your CAQH profile complete, accurate, and attested every 120 days is essential. An out-of-date profile is one of the most common causes of credentialing delays.
How long does physician credentialing usually take?+
Commercial payer credentialing often takes 60-120 days, while Medicare PECOS enrollment may take 30-60 business days and Medicaid timing varies by state. Missing documents, outdated CAQH data, payer backlogs, and contract review can extend the timeline.
Do Not Let Credentialing Delays Cost You Revenue
Start your credentialing application with B3CARE today.
We can review your payer priorities, provider documents, CAQH readiness, and contracting risks before applications start aging.