Provider Credentialing
Payer Enrollment & Credentialing
Get your providers enrolled and credentialed with insurance networks quickly. We handle application submissions, contract reviews, CAQH profile updates, and Medicare registrations.
Service Overview
Practices cannot receive in-network reimbursement unless their providers are correctly credentialed. Avera Technologies handles the complex, manual process of physician enrollment. We compile primary source documents (licensure, boards, education), build and maintain CAQH registry files, complete individual payer enrollment forms, and monitor application approvals. We also analyze commercial contract rates to renegotiate higher payer fee schedules for your practice.
Key Credentialing Features We Offer
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Payer Enrollment & Setup
Enrolling physicians with Medicare, Medicaid, Blue Cross, and major commercial insurance carriers.
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CAQH Profile Setup & Updates
Creating, updating, and re-attesting CAQH database profiles for physicians every 120 days.
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Re-credentialing Maintenance
Tracking re-validation deadlines with insurance panels to prevent network disruption or out-of-network claims.
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Contract Review & Negotiation
Analyzing payer fee schedules and drafting negotiation letters to request higher reimbursement rates.