Physician-Led Credentialing
For Nurse Practitioners, Behavioral Health Providers, Independent Physicians, and Medical Laboratories
Most new practices don’t fail clinically — they fail administratively.
Credentialing errors, missed enrollments, and poor payer strategy routinely delay reimbursement for months, even after patients are being seen.
Carolina Medical and Laboratory Management, Inc. exists to prevent that.
We help providers launch revenue-ready practices by managing credentialing, payer enrollment, and early operational alignment correctly the first time.
We specialize in helping:
Nurse Practitioners launching independent or collaborative practices
Behavioral Health providers (LCSW, LPC, PsyD) starting solo or group practices
Physicians transitioning out of hospital or employed roles
If you plan to accept insurance — now or in the near future — credentialing must be done strategically, not reactively.
We are a physician-led consulting firm that understands how credentialing, enrollment, and billing intersect in the real world.
That means:
Correct payer sequencing
Accurate provider-to-group linkage
Clean data across CAQH, NPI, and payer systems
Disciplined follow-up with insurers
Our goal is not just approval — it’s getting paid without surprises.
Designed for solo providers who want a structured, compliant launch with credentialing aligned to opening and cash-flow readiness.
Once all required information and documentation are received:
Applications or formal requests to initiate credentialing are typically submitted within 7 business days
Payer review and approval timelines are controlled by insurers and commonly extend up to 120 days, depending on payer, specialty, and state
No consultant can eliminate payer delays — but correct submission and follow-up prevent unnecessary ones.
$3,500 – $4,750 (One-Time Fee)
Pricing depends on complexity, specialty, and payer mix.
Payment Option:
50% deposit / 50% upon completion of payer application submissions
Many providers open their doors before credentialing is properly underway, assuming billing can be “fixed later.”
That approach often leads to:
Out-of-network denials
Retroactive enrollment disputes
Delayed cash flow
Costly cleanup work
Our process is designed to align credentialing and launch timing so you start seeing patients with a clear path to reimbursement.
While credentialing is a core component of our Practice Startup programs, we also provide standalone credentialing services for providers and practices at different stages of operation.
This option is appropriate for providers who already have an established business entity but require professional management of payer enrollment and credentialing.
Medicare, Medicaid, and commercial payer enrollment
CAQH setup and attestation
EFT / ERA enrollment
Application submission and follow-up
Credentialing issues often surface after a practice is already operational. We identify and resolve enrollment gaps, incorrect linkages, and payer-related issues that impact reimbursement.
Denial root-cause analysis
Enrollment corrections and resubmissions
Payer follow-up and escalation
Directory and linkage cleanup
Ongoing maintenance ensures credentialing remains current as providers, locations, and payer requirements change over time.
Re-attestations and revalidations
Demographic and practice updates
Monitoring payer participation status
Ongoing compliance support
Can you guarantee approval or exact timelines?
No. Payer decisions and timelines are controlled by insurers. What we guarantee is accurate submissions, disciplined follow-up, and proactive issue resolution.
Do you work with billing companies?
Yes. We coordinate closely with billing teams or vendors to ensure enrollment and billing are aligned.
What happens after I’m approved?
Most clients transition into ongoing enrollment maintenance to protect payer participation and avoid future disruptions.
We are a strong fit if you:
Want credentialing done correctly, not cheaply
Value transparency and realistic timelines
Plan to accept insurance and want to get paid properly
We may not be the right fit if you’re looking for guaranteed approvals or the lowest possible price.
A brief consultation allows us to:
Confirm your state, specialty, and payer goals
Identify potential credentialing challenges early
Recommend the appropriate scope and pricing