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Service
Credentialing & Contracting
Credentialing and contracting is one of the most complex and time-consuming parts of running a practice. We handle the entire process, from provider intake through payer enrollment, contract negotiation, and post-credentialing verification, with 20+ years of experience navigating it on your behalf.
Who this is for
- New providers joining an existing practice
- Practices adding new payers or expanding their network
- Providers experiencing enrollment delays or gaps
- Practices that want better contract rates with existing payers
Pain points
Credentialing delays don’t just slow things down. They stop revenue entirely.
Every day a provider sees patients without active enrollment is a day you can’t bill for. Here’s what we see most often when a practice comes to us.
Providers seeing patients they can’t bill for
Enrollment is still pending but the schedule is already full. Every visit that happens before active credentialing is complete is revenue you may never recover.
Applications sitting without follow-up
Credentialing applications get submitted and then nobody tracks what comes back. Payers have their own timelines and without consistent follow-up, applications stall and slip through the cracks.
Contracts that don’t reflect the work
Fee schedules and contract terms get accepted without negotiation because the process feels too complex to push back on. Practices leave money on the table on every single claim for the life of that contract.
What’s included
From provider intake to active enrollment and beyond.
01
Provider & practice intake
We collect all required provider and practice information, verify credentials, and build the credentialing file before any application is submitted.
03
CAQH management
CAQH profile reviewed, updated, and attested on schedule so payer applications move forward without delays caused by outdated information.
05
Contracting
Participation agreements reviewed and contract terms negotiated where possible to ensure fee schedules reflect the complexity and value of the services rendered.
07
Contract execution
Final contracts reviewed, executed, and filed with all relevant details documented for future reference and renegotiation planning.
09
Post-credentialing verification
We verify active enrollment status, confirm fee schedule loading, and follow up on any outstanding issues so nothing delays the first claim submission.
02
Credentialing file review
Existing credentialing files reviewed for accuracy, completeness, and gaps. Any missing or outdated documentation identified and corrected before submission.
04
Payer enrollment
Applications completed and submitted to all target payers, with all required documentation attached and payer-specific requirements met.
06
Contract negotiation
We advocate for better rates and terms on your behalf, backed by knowledge of payer policies and industry benchmarks.
08
Payer system setup
Once enrollment is confirmed, payer system access and billing configurations are updated so claims can go out immediately.
20+ years of credentialing experience.
We know exactly how to move the process forward, even when payers don’t.
How it works
Every step tracked. Every application followed through.
Credentialing takes time. What it shouldn’t take is your time.
1
Provider & Practice Intake
We collect all required provider and practice information, verify credentials, and build the complete credentialing file before any application is submitted.
2
Credentialing File Review
Existing files are reviewed for accuracy and completeness. Any missing or outdated documentation is identified and corrected so applications don’t get rejected for avoidable reasons.
3
CAQH Management
We review, update, and attest your CAQH profile on schedule so payer applications move forward without delays caused by outdated information.
4
Payer Enrollment
Applications completed and submitted to all target payers with all required documentation attached and payer-specific requirements met.
5
Contracting
Participation agreements reviewed and contract terms negotiated where possible to ensure fee schedules reflect the complexity and value of services rendered.
6
Contract Negotiation
We advocate for better rates and terms on your behalf, backed by knowledge of payer policies and industry benchmarks.
7
Contract Execution
Final contracts reviewed, executed, and filed with all relevant details documented for future reference and renegotiation planning.
8
Payer System Setup
Once enrollment is confirmed, payer system access and billing configurations are updated so claims can go out immediately.
9
Post-Credentialing Verification
We verify active enrollment status, confirm fee schedule loading, and follow up on any outstanding issues so nothing delays the first claim submission.
The outcome
What changes when credentialing is handled properly.
Sooner
Billing, because providers are enrolled and active before they see their first patient instead of weeks after.
No
Enrollment gaps, because every application is tracked to completion and nothing stalls without someone following up.
Better
Contract rates, because fee schedules are reviewed and negotiated instead of accepted at face value.
Less
Administrative burden, because credentialing is complex, time-consuming work that your staff shouldn’t have to manage.
“We’ve used IRMB for credentialing services, as many understand this process can be lengthy. IRMB walked us through the process very thoroughly, providing our practice with excellent tools and resources. We were able to stay up to date on every step of the process for each payer. I would highly recommend them.”
Kristie Monat
Practice Manager
Questions
Before you ask.
How long does credentialing take?
Credentialing timelines vary by payer and are largely outside our control once an application is submitted. What we control is making sure every application goes in complete, accurate, and on time, and that we are following up consistently until enrollment is confirmed.
What payers do you work with?
We work with all major commercial payers, Medicare, Medicaid, and specialty payers relevant to your practice type and geographic market. During the intake process we identify every payer you need and build a complete enrollment plan.
Can you negotiate our contract rates?
Yes. Contract negotiation is included in our contracting service. We review your current fee schedules, benchmark them against industry standards, and advocate for better rates where there is room to negotiate.
Will we have a specific person to contact?
Yes. You get a named team that knows your practice and your payers, and you can reach them directly. Most practices come to us because they couldn’t get anyone on the phone.
How is this priced?
Pricing is scoped to your practice after the discovery review, based on volume, specialty, and which parts of the cycle we’re taking on. We walk you through it in detail before anything is signed, no surprise line items.