Provider Credentialing Services
Primary source verification and CAQH management so your providers stay credentialed and in-network.
Payer-led
Approval timelines vary by application and payer
CAQH
Profile updates and attestation support
Tracked
License and credential renewal dates
Overview
Provider credentialing is the foundation that makes everything else billable - without it, claims for a provider route to denial before they're even reviewed. AspireMedX manages the full credentialing lifecycle from initial application through ongoing maintenance, for physicians, NPs, PAs, and facilities.
Where revenue usually gets stuck
Credentialing denials are rarely about the provider - they're almost always about a gap in the application: missing documentation, an expired primary source, or a CAQH profile that wasn't current when the payer pulled it. We close those gaps proactively, before they hold up a claim.
What we handle
- Primary source verification of licenses, certifications, and education
- CAQH ProView profile creation, attestation, and ongoing maintenance
- Payer application submission and follow-up tracking
- Committee review preparation and privilege applications
- Recredentialing and re-verification on payer-required cycles
- Expirable tracking - licenses, DEA, malpractice, board certifications
Questions about provider credentialing
How is credentialing different from payer enrollment?
Credentialing evaluates a provider's qualifications. Enrollment establishes the provider or group's billing participation with a payer. Contracting addresses reimbursement terms. Depending on the payer, these activities may overlap but are not interchangeable.
What information is needed to start credentialing?
Typical requests include provider identifiers, licenses, education and work history, malpractice coverage, and authorization to manage relevant applications. Exact requirements depend on the provider type and payer. Confirm the checklist before sending documents through the agreed secure channel.
Talk to us about provider credentialing
info@aspiremedx.com · +1 (716) 242-2898
Other services
Medical Billing
Outsourced medical billing services covering claim submission, payment posting, denial management, and accounts receivable follow-up.
Learn more →Medical Coding
Accurate, certified CPT, ICD-10, and HCPCS coding that holds up to payer scrutiny and audits.
Learn more →Provider Enrollment
Medicare, Medicaid, and commercial payer enrollment managed from application to active in-network status.
Learn more →