Medical Coding
AAPC-certified coders using ICD-10 and CPT to maximize reimbursement on every claim submitted.
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Core Service
Provider Credentialing
Full payer enrollment and re-credentialing services — getting your providers in-network and billing faster.
HIPAA Compliant
97%+ Clean Claims
Dedicated Account Manager
Credentialing delays cost practices thousands in lost revenue every month. Our dedicated credentialing team manages every step of the enrollment process — from CAQH profile setup through payer approval — so your providers can see patients and get paid without delays.
We handle credentialing for new providers, group practices, and multi-location clinics across all major commercial and government payers. Our systematic follow-up process keeps applications moving and prevents the months-long delays that derail so many practices.
Key Benefits
Complete Payer Enrollment
We manage credentialing with Medicare, Medicaid, and all major commercial insurers — handling every application from start to approval.
Faster Approvals
Our systematic follow-up protocol keeps your applications on payer priority queues — minimizing the enrollment window.
CAQH Management
We set up, complete, and maintain your CAQH profile — ensuring it stays current and attestation deadlines are never missed.
Re-Credentialing
We proactively track and manage re-credentialing cycles — so your network status is never interrupted by expiring credentials.
No Revenue Gaps
We coordinate credentialing timelines with billing readiness — ensuring your practice can bill from day one of patient care.
Group Practice Support
Multi-provider and group credentialing managed under one umbrella — consistent, organized, and trackable.
Our Credentialing Workflow
From initial data collection to payer approval confirmation, every credentialing application is tracked in our management system with real-time status updates provided to your practice throughout the process.
- Medicare and Medicaid enrollment (Part A & B)
- Commercial payer credentialing (BCBS, Aetna, Cigna, UHC, and more)
- CAQH profile creation, maintenance, and attestation
- Hospital and facility privileges
- NPI registration and updates
- State license and DEA verification
Related Services
Denial Management
Proactive denial prevention and rapid appeals that recover revenue most practices don't know they're missing.
Learn MoreCredentialing
Full payer enrollment and re-credentialing to get your providers billing faster without revenue gaps.
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Our free billing audit takes less than 48 hours and shows you exactly where money is slipping through the cracks.
No contracts • No setup fees • HIPAA-compliant at every step
Frequently Asked Questions
Everything you need to know about working with Prime Medical Billing for your provider credentialing needs.
Most practices see measurable improvements within the first 30–60 days. Clean claim rates typically rise within the first billing cycle as we correct root-cause coding and documentation issues. Full revenue optimization — including recovered denials and reduced AR days — is usually evident within 90 days.
No. We integrate with all major EHR and practice management systems including Epic, eClinicalWorks, Athenahealth, Kareo, DrChrono, Practice Fusion, Greenway Health, and more. Our onboarding team handles the technical setup.
Before any data is shared, we execute a formal Business Associate Agreement (BAA) with your practice. All data transfers use encrypted channels, our staff are trained on HIPAA annually, and we conduct regular security risk assessments.
Our average first-pass clean claim rate is 97–98%. We measure this as the percentage of claims accepted by payers on first submission. Each client receives a monthly performance report tracking this and other key metrics.
No denied claim goes unaddressed. Our denial management team reviews every denial within 24 hours, determines the root cause, corrects the claim, and re-submits with supporting documentation before payer appeal deadlines.