Credentialing
Done Right
Florida-based credentialing specialists handling provider enrollment, Medicare & Medicaid, commercial insurance, CAQH, and Behavioral Health credentialing — so you can focus on your patients, not the paperwork.
What We Do
End-to-End Credentialing Services
From initial enrollment to ongoing maintenance, we manage every aspect of your provider credentialing with precision — handling the complexity so you don't have to.
Federal Enrollments
Medicare and Medicaid enrollment is the foundation of your practice's revenue. We specialize in federal payer enrollment, revalidations, and compliance — so your billing never gets interrupted.
- Medicare provider enrollment
- Medicaid Florida enrollment
- PECOS registration & updates
- Revalidation management
- Group & reassignment filings
Behavioral Health Credentialing
Behavioral Health providers face unique credentialing challenges — we know them well. From Psychologists and LCSWs to Psychiatric NPs and ABA providers, we specialize in getting Behavioral Health providers enrolled and billing.
- Psychiatrists & Psychiatric NPs
- Psychologists & LCSWs
- ABA therapy providers
- Telehealth credentialing
Commercial Insurance Credentialing
We credential with Florida's major commercial carriers — BCBS, Aetna, Cigna, UnitedHealthcare, Humana, Molina, Sunshine Health, and more.
- Application submission & tracking
- Primary source verification
- Provider follow-up & status tracking
- Ongoing re-credentialing
CAQH Management
Setup, update, and maintain your CAQH ProView profile to prevent delays in claims and payer approvals. We keep you current and compliant.
- Profile setup & configuration
- Quarterly attestations
- Document uploads & updates
- Expiration monitoring
EFT Setup & Directory Verification
We enroll you for Electronic Funds Transfer (EFT) with payers so payments are deposited directly, and once you are active we verify your payer directory listing so members can find you.
- EFT enrollment with payers
- Payer directory verification once active
Ongoing Maintenance
Credentialing isn't a one-time event. We proactively manage re-credentialing cycles, expiration tracking, and payer updates so nothing ever lapses.
- Expiration alerts & renewals
- Payer status monitoring
- Address & NPI updates
- State license renewals
Federal Enrollments
Medicare & Medicaid — Done Right
Federal enrollment is the most critical — and often most complex — part of a provider's credentialing journey. Errors, missing documents, or missed revalidations can stop your billing cold. We handle it with care.
- 📋PECOS Enrollment & UpdatesWe manage your Provider Enrollment, Chain, and Ownership System (PECOS) profile from start to finish, including any updates or changes.
- 🔁Revalidation ManagementMedicare requires periodic revalidation. Miss it and your billing gets deactivated. We track your revalidation window and handle it before deadlines hit.
- 🏥Florida Medicaid EnrollmentWe navigate the Florida Medicaid enrollment portal and requirements for individual providers, groups, and facilities.
Medicare Provider Enrollment
Individual and group provider enrollment via PECOS.
Florida Medicaid
AHCA enrollment portal navigation for all provider types and specialties.
Group & Reassignment
Linking individual providers to group practices and handling billing reassignments.
Revalidation Tracking
Proactive monitoring so your federal enrollment never lapses or gets deactivated.
Behavioral Health
Credentialing for Mental Health & Behavioral Health Providers
Behavioral Health credentialing comes with its own set of payer quirks, licensure nuances, and panel availability challenges — especially in Florida. We specialize in getting Behavioral Health providers enrolled and billing.
Psychiatrists & Psychiatric NPs
Full credentialing with Medicare, Medicaid, and commercial payers including Behavioral Health carve-outs like Beacon and Magellan.
Psychologists & Therapists
Credentialing for PhDs, PsyDs, LCSWs, LMHCs, and MFTs with all major Florida health plans.
Telehealth Providers
Credentialing specifically for telehealth-only Behavioral Health practices, including platform-specific payer requirements.
ABA Therapy Providers
Enrollment for BCBAs and ABA therapy practices with Florida Medicaid and commercial insurers covering autism services.
💡 Florida-specific expertise: We understand Florida Medicaid's Behavioral Health managed care plans — including Sunshine Health, Molina, and Simply Healthcare — and the nuances of getting Behavioral Health providers credentialed with each one.
⚠️ Behavioral Health carve-outs: Many Florida health plans manage Behavioral Health through separate entities like Beacon Health Options or Magellan. This means the credentialing application goes to a different organization than the medical plan — with its own process, timeline, and requirements. We navigate this on your behalf.
🚨 Important things to know before you start:
- Not all payers recognize all license types. Some insurers do not credential LMHCs, MFTs, or CAPs. We will verify payer eligibility for your specific license before submitting.
- Panels may be closed. Behavioral Health panels are frequently closed in many Florida regions — meaning a payer is not accepting new providers in your area. This is outside anyone's control, but we will check panel status upfront so there are no surprises.
- Supervision matters. Provisionally licensed clinicians or registered interns typically cannot credential independently. If you are under supervision, we will discuss your options during our consultation.
- ABA credentialing is specialty-specific. BCBA enrollment with Florida Medicaid and commercial payers has its own documentation and group enrollment requirements separate from standard Behavioral Health credentialing.
Our Process
From Intake to Active Status
A clear, transparent process with no surprises — just steady, professional follow-through from start to finish.
Free Consultation
We assess your credentialing needs, identify gaps, and build a custom plan for your practice and specialty.
Document Collection
Our secure, HIPAA-compliant intake process collects all necessary provider documents and credentials.
Application Submission
We prepare and submit applications to all targeted payers simultaneously, with verified accuracy.
Active Follow-Up
We track every application, respond to payer requests on your behalf, and keep you updated throughout.
Approval & Maintenance
Once approved, we manage your credentialing calendar so expirations, renewals, and re-credentialing are never missed.
⏱ A Note on Timelines
We want to be upfront: most insurance payers are significantly backlogged in their credentialing processes, and approval timelines are largely outside anyone's control. What we can control is submitting complete, accurate applications the first time, following up consistently, and responding to payer requests without delay — all of which helps avoid unnecessary holdups on your end.
Why Providers Choose Us
We're a dedicated Florida-based credentialing team — not a software platform or a call center. You get real specialists who know the local landscape and are available for select out-of-state engagements on a case-by-case basis.
Focused
Our Difference
Expert Team. Honest Service.
HIPAA-Compliant & Secure
Your sensitive provider data is protected at every step with strict access controls and secure document handling.
Florida Market Knowledge
We know Florida's payers, Medicaid managed care plans, and AHCA requirements inside and out — no learning curve on your time.
Dedicated Point of Contact
You'll always know who's handling your file. A real specialist — not a rotating support queue — who picks up the phone and gives you straight answers.
Complete, Accurate Applications
The biggest cause of credentialing delays is incomplete submissions. We submit thorough, verified applications the first time to minimize back-and-forth.
About Us
Meet the Person Behind Your Credentialing
I'm Maria, Founder and Director of Credentialing & Provider Enrollment at ProviderCred Solutions. With over 12 years of hands-on experience in credentialing and payer enrollment, I've supported clinicians across multiple specialties and practice settings — from solo practitioners to growing group practices.
My background includes deep, on-the-job expertise in CAQH, NPI, Medicaid, Medicare, commercial enrollment, and compliance-aligned workflows. I am currently pursuing my NAMSS Certification — the gold standard in credentialing and provider enrollment. I've seen firsthand how the credentialing process can become a barrier for providers who just want to focus on their patients.
"I started ProviderCred Solutions to give small practices and independent clinicians a credentialing partner who values accuracy, transparency, and accountability. My goal is to simplify the credentialing process so providers can stay payer-ready and focus on delivering quality care."
Client Reviews
What Our Providers Are Saying
ProviderCred Solutions handled my Medicare revalidation and CAQH updates efficiently. They kept me informed every step of the way and made the whole process worry-free.
As a behavioral health provider, credentialing is always complicated. They knew exactly what was needed for my LCSW license and got me enrolled with Medicaid and three commercial plans.
They were transparent about payer timelines from day one — no false promises. Their follow-through was consistent and they always had answers when I had questions.
* Individual results and credentialing timelines vary based on payer processing times, provider documentation, and other factors outside of ProviderCred Solutions' control. We cannot guarantee specific approval dates or outcomes.
Get Started Today
Ready to Get Credentialed?
Click below to request your Free Consultation. A credentialing specialist will reach out within 1 business day.
Request a Free Consultation
Tell us about your practice and credentialing needs. We'll review your situation and reach out within 1 business day — no commitment required.