Lane 01 · Provider Enrollment
New providers, live and billing — without the start-date slip.
CAQH, Medicare/PECOS, Medicaid in every state, and commercial payers — tracked end-to-end on Metolius. The hire's start date holds; the billing follows on day one, not week ten.
Methodology
How enrollment works with us.
-
Document intake
Every document up front — license, DEA, board certs, malpractice COIs, work history, education, references, NPI confirmation. Documents land in Metolius; nothing lives in someone's email.
-
CAQH setup or audit
New provider? We open and complete CAQH. Existing profile? We audit for gaps, expired attestations, and the small inconsistencies that quietly stall payer applications. CAQH is the source most payers pull from — getting it right once saves weeks downstream.
-
Payer-by-payer submission
Medicare (PECOS), Medicaid (every state's portal works differently), and the commercial payers your practice bills. We submit; Metolius tracks every application from initiation through approval.
-
Follow-up until effective date
Most applications stall not because they're denied — but because someone at the payer needs one more piece of paper. We call, we email, we resubmit. Metolius shows you the latest specialist note on every application, so you know what's happening without asking.
-
Effective date, billing-ready
When approval lands, you see it in the Application Status Tracker — date, payer, line of business, group attachment. The provider can bill. Documents and approval letter stay in Metolius for audit.
Questions, plainly answered
The asks we hear about enrollment.
-
Which payers do you enroll providers with?
Medicare (via PECOS), every state Medicaid we've been asked to work with, and the commercial payers your practice bills — Aetna, Anthem and BCBS plans, Cigna, Humana, UnitedHealthcare, Medicare Advantage plans, TRICARE, VA Community Care, Workers' Compensation networks, and the regional plans on top of those. If a payer's in your mix, we work it.
-
Do I need to do anything during the process?
Provide documents, attest where the provider has to attest personally (CAQH, some Medicare steps), and answer the occasional clarifying question. Everything else is on us. You can watch progress on Metolius any time without asking for an update.
-
Can you enroll a brand-new provider with no payer history?
Yes. New residents, new attendings, providers relocating from another state, providers leaving an employed position to open a practice — all routine. Brand-new providers have a few extra steps (PECOS setup, CAQH from scratch, NPI confirmation), and we handle them.
-
What about facility enrollment — ASCs, hospitals, labs?
Yes. Facility enrollment is on a different track from individual provider enrollment (organizational NPI, CMS-855B/855A, accreditation documentation, ownership disclosures), and we do it. See the Credentialing page for facility scope.
-
How long does enrollment take?
Depends on the payer and the provider's history. Medicare PECOS approvals routinely run weeks; some commercial payers run months. Our Turnaround Time Report shows live, payer-by-payer averages from our actual workload — when you talk to us, we show you the real numbers, not a sales figure.
-
What does it cost?
Pricing depends on the number of providers, payer mix, and whether you need new enrollment or maintenance going forward. We quote after a short consult. No long-term commitment — month to month, leave with your data any time.
Get your providers enrolled — and watch the work happen.
Tell us your providers, your payers, and your timeline. A credentialing specialist replies within one business day with what enrollment looks like for your practice or facility.
Talk to us