Enrolled with the payers that matter, and kept that way.
Every day you're not enrolled with a payer is a day you can't bill them. We get you approved with the insurances that matter, and keep you compliant so network status never lapses without you knowing.
New provider
Payer enrollment
0/6
approved
- MCRMedicarePreparing
- MCDMedicaidPreparing
- TRITRICAREPreparing
- AETAetnaPreparing
- UHCUnitedHealthcarePreparing
- BCBSBlue Cross Blue ShieldPreparing
What we manage
Enroll. Maintain. Renew.
Credentialing isn't a one-time form. It's a cycle, and every stage of it is covered.
- 01Enroll
Provider enrollment
Applications prepared and submitted to commercial payers, Medicare and Medicaid, so billing can start as soon as possible.
- 02Enroll
CAQH profile setup & maintenance
Created, kept current and re-attested on schedule. An outdated CAQH profile is one of the most common causes of enrollment delays.
- 03Enroll
Application tracking & follow-up
We don't submit and wait. Applications are actively followed up with payers until approval.
- 04Enroll
Contract negotiation support
Payer contract terms and reimbursement rates reviewed before you sign, not after.
- 05Maintain
NPI & PECOS management
Individual and group NPI records and PECOS enrollments kept accurate and up to date.
- 06Maintain
Privileging support
Where applicable, hospital or facility privileging handled alongside payer credentialing.
- 07Renew
Re-credentialing & revalidation
Credentials tracked and renewed before they expire. No lost network status, no quiet removal from a payer panel.
Two kinds of payer
Government and commercial play by different rules.
Different timelines, documentation standards and reimbursement models. We manage both, so enrollment lag doesn't turn into lost revenue.
Government programs
Commercial insurance
- Timeline
- Government programsSeveral weeks or months, depending on the program, state and application requirements.
- Commercial insuranceVaries by insurance company. May take several weeks or months.
- Requirements
- Government programsStrict CMS and state-specific regulations every application has to meet.
- Commercial insuranceEach insurer sets its own credentialing policies, documentation and procedures.
- Application process
- Government programsPECOS enrollment, state applications, supporting documentation and program-specific rules.
- Commercial insuranceCAQH profiles, payer portals, credentialing forms and supporting documents, all needing ongoing maintenance.
- Reimbursement
- Government programsEstablished fee schedules and reimbursement guidelines.
- Commercial insuranceRates may be negotiated based on provider, specialty, location and payer contract.
- Where it goes wrong
- Government programsMissing information or documents lead to delays, rework or requests for more information.
- Commercial insuranceErrors or incomplete information lead to extra requests, resubmissions and avoidable delays.
Specialties
Credentialing and billing across 20+ medical specialties.
Insurance enrollment and billing tailored to the requirements of each specialty.
- Family Medicine
- Internal Medicine
- Cardiology
- Dermatology
- Neurology
- Orthopedics
- Pediatrics
- Psychiatry
- Behavioral Health
- Obstetrics & Gynecology (OB/GYN)
- Gastroenterology
- Pulmonology
- Urology
- Ophthalmology
- Dentistry
- Physical Therapy
- Pain Management
- Nephrology
- Endocrinology
- Durable Medical Equipment (DME)
Pricing
Provider credentialing starting at $99 per provider, per application.
Scope and final pricing are confirmed in writing before enrollment work begins.
What's included
12 services- Commercial payer enrollment
- Medicare enrollment
- Medicaid enrollment
- CAQH profile setup
- NPI registration & updates
- Individual provider enrollment
- Group practice enrollment
- Recredentialing & revalidation
- Demographic changes
- Payer application follow-up
- Enrollment status tracking
- Effective-date verification
FAQ
Frequently asked questions
Not seeing your question? A billing specialist will answer it directly, not a ticket queue.
Ask us directly01How is pricing structured?
Provider Credentialing starts at $99 per provider per application. Scope and final pricing are confirmed in writing before enrollment work begins.
02Why is my provider credentialing taking so long?
Credentialing delays can result from incomplete applications, missing documents, CAQH discrepancies, payer backlogs, or additional verification requirements. Torix Health manages the process and follows up with payers to help keep applications moving.
03Can Torix Health handle Medicare, Medicaid, and commercial payer enrollment?
Yes. We assist providers with Medicare, Medicaid, and major commercial payer enrollment based on their state, specialty, taxonomy, and payer requirements.
04What happens if my credentialing application is rejected or returned?
Our team reviews the reason for the rejection or return, identifies the issue, makes the necessary corrections, and works toward resubmission and continued payer follow-up.
05How long does credentialing typically take?
Timelines vary by payer, specialty and how complete the initial packet is. During consultation we set expectations for your payer mix and track status so you know what is pending versus confirmed.
06Do you handle CAQH profile setup and maintenance?
Yes. CAQH setup, updates and scheduled attestation are part of the service, because incomplete profiles are one of the most common reasons applications stall.
07What happens if an enrollment application is denied or delayed?
We review the reason, correct what we can, resubmit or escalate follow-up with the payer, and keep you informed so the practice isn't left guessing why a panel isn't active.
08Do you automatically track recredentialing deadlines?
Yes. Recredentialing is managed on a calendar with proactive follow-up before deadlines, so renewals don't lapse unnoticed.
09Is Credentialing and Contract available separately from Medical Billing?
Yes. Credentialing and Contract can stand alone or run alongside Medical Billing or Revenue Cycle Management. Many practices use it when adding providers or cleaning up enrollment lag even if billing stays in house.
10Which insurance networks do you work with?
We work across commercial and government payers common to independent practices. Scope is confirmed per engagement based on your specialty, locations and the panels you need to bill.
Next step
Let's clear the enrollment lag before it hits revenue.
Bring your provider list and the payers you need. We'll show you what's pending, what's at risk, and what we'd file first.