Provider Enrollment & Credentialing Services


When provider want to participate in health plan networks to treat insured patients and receive in-network and out of network reimbursement provider must go through a credentialing and contracting process with each health plan.  This process is referred to as “Provider Enrollment & Credentialing“.  The process varies by carrier with some initiating the process with a phone call, others have standard forms to be completed, and some require online credentialing applications be completed.  There has been some standardization of the process through CAQH, but the process still requires manual intervention and consistent follow up to ensure it is done correctly and timely.

  • Application Evaluation: Completing required documentation and identifying exceptions.
  • Primary Source Documentation: Verify practitioner/ facility information from physicians.
  • Outbound Call Center: Obtain missing documents and updating payer’s database.
  • Follow-up with payers: Follow-up on submitted credentialing requests.
  • Data Entry: Capture data, label and link images to specific providers/ facilities in payer’s database.
  • Maintenance of Provider Data: Update provider information as per policies and procedures, and CAHQ profile.


CuresMB Provider Enrollment services enable practices to get enrolled for the services they provide by ensuring that payers have the data they need to process claims for the services you provide. CuresMB constantly monitor the payers to ensure applications are received and processed on time. We work diligently to identify and resolve potential administrative issues before they impact your provider reimbursements.

  • Verification of provider information: Contact payers to determine if they have the correct provider information on file before we submit claims
  • Updating practice’s Pay-to address: Validate and update the provider’s pay-to address or the billing address
  • Enrolling for electronic transactions: Our team be able to enroll providers for four types of electronic transactions:
  • Electronic Remittance Advice (ERA)
  • Electronic Fund Transfer (EFT)
  • Electronic Data Interchange (EDI)
  • CSI
  • Monitoring process: A group of highly experienced team member’s expert to perform research and analysis on the possible processor functionality gaps