PROVIDER CREDENTIALING
Provider Credentialing Services
A provider cannot bill most payers until credentialing is complete, and delays can mean weeks or months of unpaid visits. AviRex RCM manages the credentialing process from the first application to re-credentialing, tracking each step so nothing is missed and your providers can start seeing insured patients sooner.
WHAT'S INCLUDED
What credentialing includes
CAQH profile creation, updates and re-attestation
Gathering and verifying provider documents (licenses, DEA, malpractice insurance, education and work history)
Payer applications and follow-up
Tracking of approvals, effective dates and expirations
Re-credentialing reminders and submissions
New provider onboarding for group practices
HOW IT WORKS
How it works
Collect
We gather provider information and documents.
Prepare
Profiles and applications are completed accurately.
Submit and follow up
Applications go to each payer and are tracked until approved.
Confirm
We confirm effective dates and participation status.
Maintain
We track expirations so credentials do not lapse.
WHY DELAYS HAPPEN
Why delays happen
Incomplete applications, outdated CAQH data, missing documents and slow payer responses are the most common causes. Consistent follow-up and complete submissions prevent most of them.
TIMELINES
Timelines
Credentialing time varies by payer, and some take several weeks to a few months. We give you an estimate per payer and start early.
WHY PRACTICES CHOOSE AVIREX RCM
Why practices choose AviRex RCM
- ✓Nothing lapses. We track every expiry and deadline.
- ✓Billing-aware. Credentialing is coordinated with Payer Enrollment and billing.
- ✓Single point of contact for your providers.
RELATED SPECIALTIES
We also support practices in:
COMMON QUESTIONS
Provider Credentialing Services — FAQ
It is the process by which payers verify a provider's qualifications, such as licenses, education, training and work history, before approving them to participate in their network.
CAQH is a database where providers keep their professional information, which many commercial payers use for credentialing. It must be kept current and re-attested regularly.
It varies by payer and completeness of the application. Starting early is the best way to avoid gaps.
Yes. We track dates and prepare re-credentialing submissions.
Get your providers billing sooner.
Request help with credentialing from our team.