FZ Digital Solutions
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Provider Credentialing & Payer Enrollment Support

FZ Digital Solutions provides provider credentialing and payer enrollment support as part of our managed medical billing and RCM service for U.S. healthcare providers. We handle individual and applicable group enrollment, support new providers and new locations, help with CAQH, PECOS, payer contracting and ERA/EFT enrollment, and monitor payer requests, application status and effective dates after submission. Payers make every enrollment decision and set their own timelines.

Discuss Your Credentialing Needs

Where credentialing and enrollment sit in the revenue cycle.
  1. Enrollmentbefore the first claim
  2. Advance Eligibility
  3. Prior Authorization
  4. Charge Creation
  5. Claim Submission
  6. A/R Follow-Up
  7. Denial Management
  8. Appeal Submission
  9. Patient Balance Verification
  10. Patient Statements
  11. Payment Posting (Patient, ERA/EOB)

Credentialing, enrollment and licensing: what's the difference?

Three terms often get mixed up, and they're handled by different parties:

  • Provider credentialing is the process payers and other organizations use to verify a provider's qualifications before working with them.
  • Payer enrollment is the process of enrolling a provider, and where applicable a group or practice, with an insurance payer so claims can be submitted and paid under that payer.
  • State medical or professional licensing is the authorization to practice, issued by the relevant state board.

We support credentialing and payer enrollment. State medical and professional licensing remains the provider's responsibility and is not part of our service.

Enrollment support we provide

Individual and group enrollment

We handle individual provider payer enrollment and, where applicable, group or practice payer enrollment.

New providers joining your practice

When a provider joins, we handle the payer enrollment and credentialing steps and the billing-readiness workflows needed before claims are submitted for that provider.

Adding a new location

When your practice adds a location, we handle the applicable enrollment, demographic and location updates with payers.

Provider termination updates

When you request it, we coordinate the applicable payer and system demographic or termination updates for a provider who is leaving.

Discuss Your Credentialing Needs

CAQH, PECOS and payer contracting support

Our credentialing and enrollment support includes CAQH and PECOS support, as well as payer contracting support. The specific tasks depend on your practice's needs and the scope agreed for your engagement. Payers control their contracting decisions and terms.

ERA/EFT enrollment

We support electronic remittance advice (ERA) and electronic funds transfer (EFT) enrollment with payers, so remittances and payments can be received electronically.

Tracking applications and rosters

Monitoring payer requests and effective dates

After an application is submitted, we track payer requests, application status and effective dates, so outstanding items are visible and followed up.

Rosters for multi-provider and group practices

For applicable multi-provider and group clients, we maintain provider and payer status rosters or tracking records, so you can see where each provider stands with each payer.

Payers decide whether and when an enrollment is approved. We track and follow up, but approvals and timelines are never guaranteed.

When enrollment issues cause denials

Enrollment problems can show up as claim denials. When a denial points to an enrollment issue, we verify the provider's enrollment status and effective dates, then handle the appropriate correction, payer follow-up, or appeal or reconsideration. Learn more about denial management & appeals.

Credentialing and enrollment support is delivered as part of our managed medical billing and RCM service. See how we work

Frequently asked questions

What's the difference between credentialing, enrollment and licensing?

Credentialing verifies a provider's qualifications; payer enrollment sets the provider up with a payer so claims can be billed and paid; licensing is the state's authorization to practice. We support credentialing and payer enrollment. Licensing remains the provider's responsibility.

What does your credentialing and enrollment support include?

Individual and applicable group enrollment, support for new providers and new locations, applicable termination updates when requested, CAQH, PECOS and payer contracting support, ERA/EFT enrollment, application and status tracking, rosters for applicable group clients, and handling of enrollment-related denials.

What happens when we add a new provider or location?

For a new provider, we handle the payer enrollment and credentialing steps and billing-readiness workflows. For a new location, we handle the applicable enrollment, demographic and location updates.

How long does payer enrollment take?

It varies by payer. Each payer controls its own review process, timeline and decision. We track application status and follow up, but we can't guarantee approval or a timeline.

How much does credentialing support cost?

Credentialing and enrollment support is part of our managed billing service, so pricing depends on your practice's overall scope and mutually agreed terms. We don't publish set prices; request a custom quote for your practice.

Do you handle state medical licenses?

No. State medical and professional licensing remains the provider's responsibility.

Discuss your credentialing needs

Email us a few details about your practice, your providers and locations, and the payers involved.

Please do not send patient information or PHI by email.

Discuss Your Credentialing NeedsRequest a Custom Quote