Service
ServiceCredentialing & Enrollment services for U.S. healthcare practices.
CAQH attestation, payer enrollment, and re-credentialing handled with deadline tracking. Medonix's Credentialing & Enrollment service combines AI agents with senior AAPC- and AHIMA-credentialed operators and a written SLA tied to your collections, onboarded in 30 to 60 days with zero revenue disruption.
Why this matters
Why credentialing & enrollment is harder than it looks.
Credentialing and payer enrollment is the work that decides whether a provider can bill at all. Get it wrong and a new physician sits idle for 90 days waiting on CAQH attestation, or an in-network rate gets retroactively downgraded to out-of-network. Medonix runs credentialing as a managed workflow with deadline tracking per provider per payer per state, including CAQH attestation cycles and re-credentialing windows.
How it runs
The four-step credentialing & enrollment workflow.
Every engagement runs the same four-stage process. Volume, complexity, and specialty mix change. The structure does not.
- Step 01
Roster & timeline
Build a master credentialing roster per provider per payer per state with current expiration dates and renewal windows.
- Step 02
CAQH & enrollment
CAQH attestation maintained current. New payer enrollment submitted and tracked through to effective date.
- Step 03
Re-credentialing
Re-credentialing windows opened 90 days in advance. Documents collected, attestations updated, applications submitted on time.
- Step 04
Reporting
Monthly credentialing status report per provider per payer with action items and risk flags.
Specialties served
Specialty-engineered credentialing & enrollment playbooks.
Each specialty gets its own CPT/ICD logic, payer edits, and dedicated credentialed coding team. Drag to explore.
01 · SpecialtyCardiology
Catheterization lab billing, device codes, and complex E/M leveling.
See playbook
02 · SpecialtyOrthopedics
Joint replacements, modifier 59 surgical bundling, and DME workflows.
See playbook
03 · SpecialtyOb-Gyn
Global maternity packages, ultrasound, and in-office procedures.
See playbook
04 · SpecialtyPediatrics
Vaccine VFC accounting, well-child visits, and Medicaid heavy mix.
See playbook
05 · SpecialtyMental Health & Psychiatry
Time-based therapy codes, E/M + psychotherapy add-ons.
See playbook
06 · SpecialtyDermatology
High-volume excisions, Mohs surgery, and pathology coordination.
See playbook
07 · SpecialtyGastroenterology
Screening vs diagnostic colonoscopy and endoscopy bundling.
See playbook
08 · SpecialtyNeurology
EMG/EEG technical+professional splits and infusion billing.
See playbook
09 · SpecialtyOncology
Chemo administration, drug J-codes, and prior auth-heavy regimens.
See playbook
10 · SpecialtyFamily Medicine
Chronic care, AWV, and care management add-on codes.
See playbook
11 · SpecialtyInternal Medicine
CCM, RPM, and Medicare risk-adjustment-aware coding.
See playbook
12 · SpecialtyUrgent Care
S9088 facility fees, observation, and high-throughput claims.
See playbook
Frequently asked
Credentialing & Enrollment, answered.
The questions practice owners ask before they outsource this service. Book a 30-minute call if yours is not here.
Related services
Often combined with credentialing & enrollment.
Practice Management Consulting
Operational diagnostics, fee-schedule analysis, and KPI dashboards.
See serviceValue-Based Care
Quality reporting, attribution, and shared-savings program enablement.
See serviceStaffing & Virtual Team
Dedicated virtual billers, schedulers, and AR specialists embedded in your workflow.
See service
Talk to RCM
Ready to recover every dollar your practice earns?
See your projected revenue lift in 60 seconds, or talk to a senior RCM strategist now. No commitment. Same-day slots available.
- 30-day parallel-run guarantee
- Targets written into the contract
- HIPAA · SOC 2 Type II · HITRUST