Medical Credentialing Services, Affordable, Simplified & Compliance Guaranteed.

CNS helps healthcare organizations outsource the complex process of provider and physician credentialing, ensuring speed, accuracy, and full transparency throughout payer enrollment.

What We Handle

Our credentialing experts function as a seamless part of your team making sure every application is completed accurately, verified thoroughly, and submitted right the first time.

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Provider Enrollment

We work directly with Medicare, Medicaid, and commercial insurers to enroll new providers and group practices quickly and correctly.

CAQH Management

We maintain and update your CAQH profile, monitor deadlines, and ensure timely attestations.

Re-Credentialing

We manage all renewals, updates, and compliance checks to keep your practice in good standing with every payer.

Application Tracking

Get real-time updates on every application status, milestones, and payer feedback all in one place.

Your assigned account manager and provider portal give you complete transparency, ongoing communication, and total control over every credentialing process from start to finish.

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Why Providers Choose CNS

• Cuts credentialing administrative costs by as much as 80% through automated AI workflows

• Speeds up provider onboarding by up to 90% using real-time CAQH synchronization and a centralized Provider Hub

• Delivers a 99.8% accuracy rate, verified against more than 1,500 primary-source validation rules

• Keeps credentialing-related claim denials to a minimum through continuous status monitoring

Our Full Range of
Physician Credentialing Solutions

Government Program Enrollment

Medicare and Medicaid Enrollment: Secure approval to serve eligible patients under these essential federal healthcare programs

Medicare DMEPOS Enrollment: Targeted assistance for providers who supply durable medical equipment, prosthetics, orthotics, and related items

Commercial Insurance Credentialing

Our physician credentialing support works smoothly with leading commercial payers.

Credentialing services combined with skilled contract negotiation to secure stronger terms and optimize reimbursement rates

Essential Registrations

NPI Registration: We manage both Type I (individual) and Type II (organizational) NPI setup.

CAQH Profile Management: We build and maintain your Council for Affordable Quality Healthcare profile to streamline data sharing with participating insurers

PECOS Support: We oversee activity within your Medicare Provider Enrollment, Chain, and Ownership System portal

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Licensing and Certification

State licensing applications and renewals: We ensure providers meet all regulatory requirements for their practicing jurisdictions

U.S. DEA registration management: We handle the steps required for providers to legally prescribe and manage controlled substances

CLIA certification support: We assist in meeting federal laboratory quality standards established under the Clinical Laboratory Improvement Amendments (CLIA)

Hospital Privileges

We manage a simplified, efficient application process with partnering hospitals, helping you broaden your clinical reach and overall patient care capacity

Ongoing Support

Revalidation and Recredentialing: Keep your payer status active and current
Reimbursement issue audits: We analyze and correct problems that disrupt your revenue cycle
NCQA compliance oversight: We ensure alignment with the standards set by the National Committee for Quality Assurance

Why Work The CNS Billing and Credentialing Services

Dedicated Expert

A skilled team manages all documentation, follow-ups, contracting challenges, and data accuracy throughout the process

Comprehensive Support

End-to-end management covering information collection, submissions, tracking, and communication

Personalized Attention

A dedicated project manager oversees your entire credentialing workflow

Growth Catalyst

Strengthen your practice by expanding participation across more networks

Time-Efficient

Shortens credentialing timelines significantly, moving from months to week

24/7 Access

Track application progress at any time through our secure online portal

Awards /Testimonials

“Joining insurance panels felt impossible until CNS stepped in. They navigated the entire system for me and saved my practice countless hours.”

Jasmine Patel, LCSW

Frequently asked questions

General

Turnaround times differ by insurance carrier. Most major carriers complete the process within 90–120 days, while smaller plans can take even longer. After a provider submits a participation request, two steps occur:

Credentialing: The carrier verifies all documents, checks qualifications, and sends the file to its credentialing committee for approval.
Contracting: Once approved, the provider moves into contracting, where participation is finalized and an effective date is issued.

Commercial insurers do not permit retroactive billing. Providers can only bill and get paid for services rendered after they are officially listed as in-network in the carrier’s system. Anything performed before that point is considered out-of-network and may leave patients responsible for significantly higher costs.

Enrollment in Medicare usually takes 60–90 days, but the exact timeline depends on the state. The effective date is the day Medicare receives the application, which allows providers to bill retroactively for any services delivered between submission and approval. Medicare also grants a 30-day look-back window, meaning providers can bill for services rendered up to 30 days before the effective date.

For DMEPOS suppliers (durable medical equipment, prosthetics, orthotics, and supplies), processing takes longer. Applications face stricter review, and suppliers must complete a mandatory site visit. During this visit, inspectors verify the physical location, posted operating hours, inventory storage, and other compliance requirements needed to qualify as a DMEPOS supplier.

Yes. Providers must have an established place of service before beginning credentialing and contracting. A home address cannot serve as a clinical practice address—whether temporarily or permanently. It may be used only for billing or mailing, and only if a separate physical practice location is listed.

If your office space is still being built, you can still use that address. Applications may be submitted up to 30 days before the official opening, and most commercial payers follow the same rule.

Medicare requires providers to revalidate every five years, while DMEPOS suppliers must revalidate every three years. Individual practitioners can complete revalidation by submitting a CMS-855I paper application or by using PECOS to file electronically.

You must respond to your Medicare contractor within 60 days of receiving the revalidation notice. Failure to do so can result in loss of billing privileges.

For groups or suppliers, revalidation is done using the CMS-855B. If the group does not already have an electronic funds transfer (EFT) on file, one must be set up as part of the revalidation process.

The CMS-855I is the primary application for individual provider enrollment in Medicare. Both physicians and non-physician practitioners use this form. Additional documentation depends on provider type.

You may also need supporting forms:

• CMS-460 – Used to choose participating status with Medicare. Without it, a provider may default to non-participating status, which pays lower reimbursement but allows limited balance billing (up to 115% of the Medicare fee schedule).

• CMS-855R – Required when a provider joins an existing group. It reassigns Medicare payments to the group practice. – If the provider is already enrolled in that jurisdiction: submit only CMS-855R. – If not yet enrolled: submit CMS-855I + CMS-855R.

• CMS-588 – Required for both individuals and groups to set up electronic funds transfer (EFT). Medicare does not issue paper checks.

Summary of forms:

• Solo provider forming a new practice: CMS-855I, CMS-460, CMS-588 • Provider joining a group (already enrolled): CMS-855R • Provider joining a group (not enrolled): CMS-855I + CMS-855R • CMS-460 may be required depending on the group’s participation status

A CP575 is the official IRS letter issued when a business is first assigned an Employer Identification Number (EIN). Medicare requires this document as proof of the business’s legal name when submitting an enrollment application.

If the original CP575 is lost, the IRS can issue a 147C letter, which serves as an acceptable replacement. Medicare accepts only the CP575 or the 147C as valid EIN verification.