PAYER ENROLLMENT
Payer Enrollment Services
Even a fully credentialed provider cannot be paid until they are enrolled with each payer and linked to the practice's billing information. AviRex RCM manages payer enrollment for individual providers and groups, with Medicare, Medicaid and commercial plans, so claims are paid under the right contracts.
WHAT'S INCLUDED
What payer enrollment includes
Medicare (PECOS) and Medicaid enrollment support
Commercial payer contracting and enrollment applications
Group and individual provider linkage
Updates for address, tax ID, ownership and provider changes
Revalidation and recertification tracking
Follow-up until effective dates are confirmed
HOW IT WORKS
How it works
Review
We identify the payers you need based on your patient mix.
Apply
Enrollment applications are completed and submitted.
Follow up
We track each application until approval.
Verify
We confirm effective dates and that claims will process correctly.
Maintain
We handle revalidations and changes.
CREDENTIALING VS ENROLLMENT
Credentialing versus enrollment
Credentialing verifies a provider's qualifications. Enrollment sets up the provider as a participating provider with the payer so claims are paid. They are related, and we manage both together. See Provider Credentialing.
PROBLEMS WE HELP AVOID
Common problems we help avoid
- ✓Claims denied because the provider is not yet enrolled
- ✓Wrong effective dates or missing group linkage
- ✓Lapsed revalidation causing payment holds
- ✓Outdated practice information on file with payers
WHY PRACTICES CHOOSE AVIREX RCM
Why practices choose AviRex RCM
- ✓End-to-end tracking across all payers.
- ✓Coordinated with billing so claims are not submitted too early.
- ✓Clear status reports on every application.
RELATED SERVICES
This service works closely with:
RELATED SPECIALTIES
We also support practices in:
COMMON QUESTIONS
Payer Enrollment Services — FAQ
Payer enrollment is the process of registering a provider or group with an insurance payer so they can bill and be paid under that payer's plans.
Yes. Each payer has its own application and requirements.
Yes. We manage updates with each payer to keep records accurate.
Avoid claim delays caused by enrollment gaps.
Get help with payer enrollment from our team.