Lane 02 · Credentialing & Privileging
Documentation discipline, delivered on the timeline you need it.
Initial credentialing, hospital privileging, and facility credentialing — for providers and organizations. Primary-source verification, committee follow-up, audit-ready packets. Every application visible on Metolius.
Methodology
How credentialing works with us.
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Scope the credentialing event
New provider? New facility? Hospital privileges? A scope-of-practice change? Each event has a different document set and a different reviewer at the payer or hospital. We map it before we start so nothing surprises the application halfway through.
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Primary-source verification
License, DEA, education, training, board status, hospital affiliations, malpractice history, work-history continuity. We verify at the source — state board, NPDB, AMA, ABMS — not from PDFs in someone's drive. Primary-source verification is what payers and hospitals actually require; we do it the way they expect to receive it.
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Application assembly + submission
Each payer or hospital wants the same information in a different format on a different portal. We assemble once, submit per recipient, and tag every application in Metolius so it shows up on the Status Tracker the same day.
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Committee follow-up
Hospital credentialing committees meet on a cycle. Payer committees move on their own clocks. We watch the calendar, push for the next meeting, and respond to committee questions within the day — not the week.
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Approval, IDs, and platform record
Approved. Effective date, provider/payer/facility ID numbers, and the credentialing letter all land in Metolius. The next renewal date is set on the Credential Expiration Report the same day approval comes through — so the maintenance work starts before anything can lapse.
Questions, plainly answered
The asks we hear about credentialing.
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What's the difference between credentialing and provider enrollment?
Credentialing is the verification process — confirming a provider has the license, training, and history they claim. Enrollment is the payer-side step of getting that credentialed provider into a payer's network so they can bill. Most projects need both; we do both as one engagement so nothing falls between the cracks.
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Do you do hospital privileging?
Yes. Hospital privileging is its own track — medical staff bylaws, department-specific privilege lists, committee review, peer references, NPDB query, focused/ongoing professional practice evaluation setup. We have run privileging at hospitals across the country and we work the calendar so a provider is privileged before the start date, not after.
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What facility types do you credential?
Ambulatory surgery centers, hospitals (acute, critical access, specialty), labs, imaging centers, dialysis centers, urgent care, FQHCs, and infusion centers. Each has its own combination of CMS enrollment, payer credentialing, and accreditation requirements; we've done them.
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How do you handle multi-state providers?
State-by-state. Every state Medicaid has its own portal and its own rules; every state has its own license verification path; commercial payers are usually national but with regional review teams. Metolius tracks each state's status separately so a provider licensed in five states shows five enrollment threads, not one collapsed status.
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What if our credentialing is already in flight somewhere else?
We pick it up. Send us what you have — application IDs, payer contacts, where each application sits — and we take it from there. Metolius is built for handoffs; we don't need to start over to track the work.
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Is there a long-term commitment?
No. Month to month. Metolius stays with the engagement; your data stays yours; you leave with it any time we're not earning the work.
Get the credentialing closed — on the schedule you need.
Tell us the provider or facility, the payers or hospitals, and the deadline. We'll tell you what the credentialing path looks like and show you Metolius.
Talk to us