Understanding Our Services
What is Provider Credentialing?
Provider credentialing is the process of verifying a healthcare provider's qualifications and enrolling them with insurance companies so they can participate in payer networks and receive reimbursement for services rendered. Credentialing ensures providers meet regulatory, professional, and payer-specific requirements before they begin treating patients under an insurance plan.
Without proper credentialing, providers may experience delays in reimbursement, claim denials, or an inability to bill insurance altogether—resulting in lost revenue and interruptions to patient care.
At CJC Healthcare Solutions, we simplify the credentialing process by managing each step from application preparation through payer enrollment and ongoing maintenance. Our goal is to minimize administrative burden, reduce enrollment delays, and help providers become and remain participating with Medicare, Medicaid, and commercial insurance plans.
Our Credentialing Services Include:
Medicare Provider Enrollment (PECOS)
State Medicaid Enrollment
Commercial Insurance Enrollment
Group Practice Enrollment
CAQH Profile Creation & Maintenance
NPI Registration & Updates
Recredentialing Services
Provider Demographic Updates
Hospital Privileging Assistance
Provider Roster Management
Medicare & Medicaid Revalidation
Credentialing Status Tracking
Payer Follow-Up & Issue Resolution
Provider Credentialing Packages starting at $750 per provider.
Pricing varies based on the number of providers, payer enrollments, and services selected.
What is Revenue Cycle Management?
Revenue Cycle Management (RCM) is the financial process that healthcare organizations use to manage every stage of the patient revenue cycle—from scheduling an appointment and verifying insurance eligibility to claim submission, payment collection, denial resolution, and financial reporting.
Medical billing is one critical component of the revenue cycle, but effective revenue cycle management extends far beyond simply submitting insurance claims. It requires continuous oversight, strategic planning, workflow optimization, and proactive financial management to ensure healthcare organizations receive timely and accurate reimbursement for the care they provide.
At CJC Healthcare Solutions, we take a comprehensive approach to revenue cycle management by combining accurate medical billing with proactive claims management, denial prevention, performance monitoring, and operational consulting. Our goal is to improve cash flow, maximize reimbursement, reduce administrative burdens, and strengthen the overall financial health of your practice.
Our Revenue Cycle & Medical Billing Services Include:
Charge Entry (if applicable)
Electronic Claims Submission
Payment Posting (ERA & Manual)
Insurance Follow-Up
Denial Management & Appeals
Secondary Claims Processing
Patient Statements
Accounts Receivable Management
Credit Balance Resolution
Clearinghouse Management
Revenue Cycle Assessments
Revenue Cycle Consulting
Customized Pricing
Revenue Cycle Management and Medical Billing services are tailored to each practice based on provider count, claim volume, specialties, service requirements, and operational complexity. Following a complimentary consultation, we'll provide a customized proposal designed to meet your organization's unique needs.
Why Choose CJC Healthcare Solutions?
Experienced Leadership – Led by a healthcare administration professional with extensive experience in revenue cycle management and provider operations.
Personalized Service – Every client receives customized solutions tailored to their practice's unique goals and challenges.
Proactive Communication – Transparent updates and responsive support throughout every engagement.
Comprehensive Solutions – From credentialing to revenue cycle optimization, we provide end-to-end administrative support.
Results-Focused Approach – Our commitment to Billing. Accuracy. Results. drives everything we do, helping healthcare organizations improve financial performance while maintaining compliance and operational excellence.