Credentialing

Provider Credentialing & CAQH Enrollment Services

At TKM Billing Solutions Inc., we understand that provider credentialing is the foundation of a successful revenue cycle. Without proper enrollment and network participation, claims cannot be processed or reimbursed. That’s why we offer comprehensive credentialing support designed to remove administrative barriers and accelerate your path to payer approval.

Our team provides expert guidance through the Council for Affordable Quality Healthcare (CAQH) Provider Data Portal, the industry-required credentialing system used by most major insurance carriers. We ensure your provider profile is accurate, compliant, and optimized to meet payer requirements.

We assist providers with credentialing and network access requests for:

• Anthem Blue Cross and affiliated PPO/HMO networks

• Blue Shield of California

• Aetna

• Cigna

• UnitedHealthcare

Our Credentialing Support Includes:

✔ CAQH profile creation, completion, and optimization

✔ Document collection and compliance review

✔ Provider attestations and quarterly re-attestation monitoring

✔ Submission of credentialing applications to insurance carriers

✔ Direct payer follow-up and status tracking

✔ Assistance with group and individual provider enrollments

✔ Ongoing credentialing maintenance to prevent network disruptions

With over 30 years of industry experience, TKM Billing Solutions Inc. delivers a hands-on, concierge-level approach to credentialing. Our goal is to simplify the enrollment process, reduce delays, and ensure your practice is positioned to begin billing and receiving payments as quickly as possible.

Whether you are a new provider, expanding your practice, or adding additional insurance networks, our team is here to support you every step of the way.

Key Benefits

• Accelerated Enrollment We leverage specialized knowledge of payer requirements and use efficient processes to significantly reduce the typical application-to-approval timeline.

• Minimized Errors & Denials Our specialists ensure every application is complete and accurate before submission, virtually eliminating common mistakes that cause delays, rejections, or denials.

• Proactive Compliance We manage all re-credentialing deadlines, CAQH re-attestations, and state-specific requirements (like Medicaid revalidation) proactively.

• Cost Efficiency Converting credentialing from an in-house fixed cost (salaries, training, resources) to a variable, outsourced service.

• Focus on Core Operations By handling this complex administrative task, we free up your internal resources (billing, administrative staff, and providers).

• Faster Revenue Cycle Providers can begin billing under new payers sooner, increasing cash flow.