Practice Management services

Credentialing Services

Provider enrollment and Medical Credentialing Services is a long and complicated process where a Provider’s experience and qualifications are reviewed for the purpose of enrolling them with Government and commercial payors. As an extension of our Practice Management services, CBS provides a wide range of credentialing services.

We offer the following services:

  • Individual and Group NPI application.
  • NPPES and Pecos Management.
  • CAQH enrollment and Maintenance.
  • Medicare enrollment for Individual NPI’s and Group NPI.
  • Contract negotiations
  • Re-validation and maintenance of provider data in PECOS.
  • Individual and Group Medicaid enrollment.
  • Individual NPI credentialing for commercial payors.
  • Group NPI and Group contract negotiation for commercial payors.
  • Workers Compensation contracts and fee negotiation.
  • University and College Health center credentialing.

Our clients have included:

  • Colleges
  • Hospitalists contracts.
  • Multiple providers offices and groups.
  • Medicare and Pecos Applications.
  • Government Health Systems.
  • Multiple Workers Compensation and Occupational Medicine contracts.

Need help with credentialing? See our proven process.

Credentialing Checklist

Individual’s information

  • Full Name
  • SSN
  • Date of Birth
  • Resume in its entirety. (No job gaps over 6 months, if any please explain)
  • NPI numbers Individual:
  • DEA for each state (copy)
  • State Medical License (copy)
  • Specialty – Board Certified. (copy)
  • Letter confirming hospital admitting privileges or arrangements
  • Five professional references with address and contact information
  • Are physicians US citizens? (If not, provide VISA information)
  • Will physicians be considered Specialists or Primary Care Physicians?
  • Current Malpractice Information: Copy of Liability Insurance Certificate
  • Malpractice claims history if any or any other criminal charges pending against you. Ever been arrested.
  • CAQH login information as well as CAQH ID. https://proview.caqh.org.
  • Medicare number. If none assigned, please provide access to this site: https://pecos.cms.hhs.gov/

Group’s Information

  • Group NPI
  • Voided Check / Local Branch / Contact and Branch and contact Information
  • CP – 575 IRS form
  • Hours of operation
  • All Location addresses. Billing address if different
  • Group Phone and Fax number
  • Medicare number. If none assigned, please provide access to this site: https://pecos.cms.hhs.gov/
  • Office Manager or Business Staff Contact
Download PDF version

California Credentialing Checklist

Individual’s information

  • Full Name
  • SSN
  • Date of Birth
  • Resume in its entirety. (No job gaps over 6 months, if any please explain)
  • Individual NPI number
  • DEA for each state (copy)
  • State Medical License (copy)
  • Specialty – Board Certified. (copy)
  • Letter confirming hospital admitting privileges or arrangements
  • Five professional references with address and contact information
  • Are physicians US citizens? (If not, provide VISA information)
  • Copy of driver's License
  • Current Malpractice Information: Copy of Liability Insurance Certificate
  • Malpractice claims history if any or any other criminal charges pending against you. Ever been arrested.
  • CAQH login information as well as CAQH ID. https://proview.caqh.org.
  • Medicare number. If none assigned, please provide access to this site: https://pecos.cms.hhs.gov/

Group’s Information

  • Group NPI
  • Voided Check / Local Branch / Contact and Branch and contact Information
  • CP – 575 IRS form
  • Hours of operation
  • All Location addresses. Billing address if different
  • Group Phone and Fax number
  • Medicare number. If none assigned, please provide access to this site: https://pecos.cms.hhs.gov/
  • Office Manager or Business Staff Contact
  • Fictitious Name Permit
  • Access to PAVE Portal: https://pave.dhcs.ca.gov/sso/login.do/
Download PDF version

Solution to your credentialing needs

We look forward to assisting and helping with your credentialing needs. Please call us at 877-614-5227 or email us at the Contact us page..

Marie Wilkerson

We have used Capital Billing Services on several occasions for the credentialing of our providers. Very professional and efficient. James answered all my questions and made sure we were able to be participate with insurance as quickly as possible. I highly recommend James and his staff. They will go above and beyond for you.

Pilcher Staff

James and his staff stayed with us throughout the lengthy and frustrating process that is credentialing/contracting! They responded quickly whenever I emailed or called. They were organized and persistent. Couldn’t have done it without them. Thank you Capital Billing!