A provider can’t be paid by an insurance plan until they’re credentialed and enrolled with it. Credentialing is detailed, slow, and easy to get wrong, and a missed revalidation or an out-of-date profile can quietly stop payments that the practice was counting on.
Elevate handles credentialing and payer enrollment for new providers, new locations, and existing providers who need to be re-credentialed, and it tracks the deadlines so enrollments don’t lapse.
This orthopedic practice was losing thousands monthly due to preventable denials and poor documentation. After restructuring their billing workflow and improving coding accuracy, we slashed their denial rate by 60% and restored consistent reimbursements.
It’s the process of verifying a provider’s qualifications with an insurance plan and enrolling them so the plan will pay for their services.
Common causes are a provider who was never fully enrolled, an expired revalidation or CAQH attestation, or a change in address or tax ID that wasn’t updated with the payer.