What is Credentialing?

Robust Credentialing process helps the Healthcare organizations realize the revenues faster. Credentialing for Provider organizations include Physician/Provider enrollment and attestation with the Payer’s network and authorized to provide services to patients who are members of the Payer’s plan. The credentialing process validates that a Physician meets the standards for delivering the clinical care, wherein the Payer verifies the Physician’s education, license, experience, certifications, affiliations, malpractice, any adverse clinical occurrences, and training.

Signature issues with lack of credentialing process include:

Our Solution

Our data-driven approach tremendously augments and accelerates the credentialing process. Use of AI and Intelligent Automations to automate the verification and validation of the credentialing processes and streamline the end-to-end credentialing processes.

Our data-driven approach involves:

  • Collection all the data and documents required for filing the credentialing applications from the physicians
  • Storing the documents centrally on our secure document management system
  • Identification of the payers to which the practice sends the claims and initiate the contact with the payers
  • Apply the payer-specific formats after a due audit
  • Timely follow-up with the payers to track the application status
  • Obtain the enrollment number from the Payer and communicate the state of the application to the physician
  • Periodic updates of the document library for credentialing purposes


  • Get credentialed faster with the Payers with reduced cost and effort
  • Get more patient referrals from the network
  • Gain competitive edge
  • Avoid piles of paperwork through digitization of the documents
  • Reduce claim denials and improve cashflow
  • Get real-time status of the applications
Let’s build future together