Home Specialties Nurse Practitioner & Physician Assistant
Advanced Practice Providers

Credentialing & Payer Enrollment
for Advanced Practice Providers

Helping Nurse Practitioners, Physician Assistants, CRNAs, and CNMs navigate Full Practice Authority (FPA) laws, Incident-To billing, and Collaborative Practice Agreements (CPAs) to maximize reimbursements.

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45 Days
Avg. Credentialing Timeline
98%
First-Time Claim Acceptance
50
APRN Compact & Local Paneling
100%
CAQH & PECOS Compliance
Who We Help

Tailored Enrollment for Mid-Level Providers

Expert credentialing solutions designed exclusively for advanced practice providers — from independent NPs in Full Practice Authority states to PA-Cs linked to supervising physicians.

Nurse Practitioners (NPs) — Whether you are launching an independent practice in a Full Practice Authority (FPA) state or joining a multi-specialty group, we handle your paneling and NPI Type 2 setup.
Physician Assistants (PAs) — We streamline the complex process of linking PA-Cs to their supervising physicians, managing your Delegation of Services Agreements (DSA) for commercial payer compliance.
CRNAs & Nurse Midwives — Specialized credentialing and hospital privileging for Certified Registered Nurse Anesthetists and Certified Nurse Midwives (CNMs), securing highly profitable commercial contracts.
Provider Types:
FNPs PMHNPs AGNPs PNPs WHNPs CNSs ENPs APRNs PA-Cs Surgical PAs CRNAs CNMs
Complete APP Credentialing & PECOS Enrollment

From CAQH ProView & Medicare PECOS (CMS-855I/855R) setup to Incident-To billing configuration — we handle every step so you can focus on patient care.

98%
Approval Rate
45
Avg Days
50
States
500+
Payers
In-Network Paneling for: UHC, Cigna, Humana, Aetna, BCBS, Tricare & Medicare
Starting from $100/application · No hidden fees
Explore our 4-step payer enrollment process
Average Timeline: 45–60 days (vs. 90–120 industry standard)
Service 02

Navigating the Complexities of Nurse Practitioner & Physician Assistant Billing Rules

Most credentialing companies don't understand the nuances of mid-level provider enrollment. Our team consists of experts who know the exact state-by-state Scope of Practice laws.

Independent vs. "Incident-To" Billing Setup — Should you bill under your own NPI at 85% of the Medicare fee schedule, or use your supervising physician's NPI for 100% reimbursement? We analyze your state's Scope of Practice laws to determine the most profitable legal billing structure.
Collaborative Practice Agreements (CPA) — Operating in a Restricted or Reduced Practice state? We ensure your collaborative physician's credentials are seamlessly linked to your CAQH ProView and Medicare PECOS profiles to prevent sudden claim denials.
Medicare PECOS & Reassignment (855I & 855R) — Medicare enrollment for advanced practice providers is notoriously strict. We expertly process your NPPES updates, CMS-855I (Individual Enrollment), and CMS-855R (Reassignment of Benefits) forms via the I&A system.
Split/Shared Visits & Surgical Modifiers — We ensure your practice is correctly credentialed to utilize the AS modifier for surgical assists and proper billing codes for split/shared E&M visits in facility settings.
We Don't Take No For An Answer

Our credentialing experts know the exact verbiage and workflows required to bypass standard rejections and push your file to approval.

Every Month Without Credentialing:
$10,000–$15,000 in lost revenue per uncredentialed provider
Advanced Billing & Enrollment Expertise:
AS Modifier (Surgical Assist) Integration
CMS-855I & 855R Form Processing
Delegation of Services Agreement (DSA) filing
Supervising Physician Linkage
Key Capabilities:
CAQH Maintenance PECOS Enrollment Medicare Reassignment NPI Type 2 Setup Fee Schedule Negotiation NP Panelling
Our Process

The 4-Step APP Credentialing Process

1

CAQH & State License Audit

We verify your APRN/PA state licenses, multi-state APRN Compact privileges, board certifications (AANP, ANCC, NCCPA), and DEA numbers.

2

Collaborative Linkage

We link your supervising physician’s NPI to your payer applications to ensure immediate approval in restricted states.

3

Payer Application Submission

We submit pristine applications to Medicare, state Medicaid (MCOs), and major commercial networks (BCBS, Aetna, Cigna, UHC).

4

Contract & Roster Management

Once paneled, we secure your network contracts and manage your group rosters, easily unlinking old physicians and adding new ones as your staff changes.

Nationwide Coverage, State-Specific Expertise

APP credentialing rules and Collaborative Practice Agreements change the second you cross state lines. Because we operate nationwide, we understand the exact nuances of FPA states vs. restricted states.

Get Started Nationwide
Insurance Networks

In-Network Paneling for Major Healthcare Payers

We navigate the complex specific requirements for the nation's largest medical networks, Medicare MACs, and commercial payers.

Medicare
Regional MACs
UnitedHealthcare
UHC Commercial & MA
Cigna
Commercial Networks
Humana
Commercial & Military
BCBS
Blue Cross Blue Shield
Aetna
CVS Health
Tricare
Military & Veterans
Medicaid
State MCOs

Beyond Paneling: Fee Schedule Negotiation & Contracting

Getting approved by an insurance panel is only half the battle. We also handle the contracting phase. This ensures that your advanced practice services are reimbursed at a profitable rate, whether you are billing independently or under Incident-To rules. We help group practices leverage their size to negotiate better fee schedules with major payers.

FAQ

Advanced Practice Credentialing FAQs

Common questions about our Nurse Practitioner and Physician Assistant credentialing services.

Do NPs and PAs get reimbursed at the same rate as physicians?

Under Medicare rules, independent NPs and PAs are typically reimbursed at 85% of the Physician Fee Schedule. However, if billed properly under "Incident-To" rules with a supervising physician on-site, services can be reimbursed at 100%.
You must submit a CMS-855R form (or update via PECOS) to terminate the reassignment of benefits with the old physician and establish a new reassignment with the incoming supervising physician. We handle this entire update process.
Yes. If you hold licenses in Full Practice Authority (FPA) states, we can panel your independent virtual practice across multiple states without the need for a collaborative physician.
Credentialing and enrollment allow you to bill commercial payers and Medicare. Privileging is the internal hospital process that grants you permission to practice inside their facility. We assist with both.

Ready to Fast-Track Your Nurse Practitioner or Physician Assistant Credentialing?

Stop fighting with PECOS rejections and confusing state board requirements. Let Exp Credentialing Services handle your payer enrollment so you can focus on patient care.

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