Nexcore Healthcare Solutions

Provider Credentialing & Enrollment

Reliable Credentialing Solutions for Healthcare Providers

We manage every stage of the credentialing process — from initial applications to ongoing recredentialing and payer follow-ups — keeping providers compliant, properly enrolled, and ready to receive reimbursements without delays.

Our Credentialing Services

Initial Credentialing

  • Documentation review
  • Provider application preparation
  • Credential verification
  • Application submission
  • Enrollment tracking and follow-ups
  • Approval confirmation

Recredentialing Services

  • Credential renewal tracking
  • Document updates
  • Payer communication
  • Revalidation submissions
  • Profile maintenance

Medicare & Medicaid Enrollment

  • Medicare enrollment
  • Medicaid enrollment
  • PECOS registration
  • Revalidation
  • Provider updates and changes
  • Reactivation

Revalidation & Reactivation Services

  • Medicare / Medicaid / Commercial payer revalidation
  • Provider reactivation support
  • Deactivated provider enrollment recovery
  • PECOS reactivation assistance
  • Document collection and submission
  • Payer communication and follow-ups

Demographic & Ownership Updates

  • Practice address, phone, fax updates
  • Tax ID and ownership changes
  • Provider additions and terminations
  • Group affiliation updates
  • Banking, EFT and ERA enrollment updates
  • Credential and license updates

Contract Negotiation Services

  • Commercial Insurance Contract Negotiation
  • Fee Schedule Analysis & Optimization
  • Reimbursement Rate Review
  • Medicare Advantage / Medicaid MCO Contract Assistance
  • New Payer Contract Setup
  • Market Rate Benchmarking

CAQH Profile Management

  • CAQH profile setup
  • Profile maintenance
  • Document uploads
  • Quarterly attestations
  • Information corrections and updates

Payers We Work With

  • UnitedHealthcare
  • Aetna
  • Cigna Healthcare
  • Blue Cross Blue Shield
  • Humana
  • Carelon
  • Molina Healthcare
  • Kaiser Permanente
  • Medicare Advantage Plans
  • Medicaid Managed Care Plans
  • Tricare

Benefits of Professional Insurance Credentialing

  • Reduce claim denials
  • Improve reimbursement timelines
  • Minimize administrative workload
  • Maintain payer compliance
  • Avoid credentialing delays
  • Improve provider onboarding efficiency
  • Expand insurance network participation

Start Your Credentialing

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Start Your Credentialing