Payer Enrollment and Contracting
Commercial, Medicare, and Medicaid enrollment through to effective date.
Get clinicians billable in weeks instead of months. CareLumi manages group and individual payer applications, runs persistent follow-up cadences, and secures network participation.
How the work is done
Automated by CareLumi. Signed off by people.
Automated by CareLumi
- Pre-filling of payer-specific enrollment applications (Commercial, Medicare Part B, Medicaid MCOs).
- Automated follow-up cadence tracking across payer portals, phone queues, and email workflows.
- Revalidation and re-credentialing deadline tracking across every active health plan.
- CMS access and permissions setup for organizations, facilities, and individual NPIs.
Human-in-the-loop sign-off
- Human contract and attestation review prior to provider/practice signature.
- Direct payer representative escalation for stalled applications or network panel inquiries.
Key outputs & deliverables
What your team receives.
- Real-time Payer Enrollment Work Queue (In Progress, Needs Info, Active).
- Complete communication log recording every phone call, portal update, and email with payers.
- Effective billing date notifications and provider ID (PTAN/Payer ID) confirmation.
Payer enrollment work queue
- Effective date confirmed. Payer ID recorded.
- Application in review. Last follow-up logged 3 days ago.
- Payer requested an updated W-9 for the practice.
- Contract received. Human review before signature.
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Talk with us about Payer Enrollment and Contracting.
Tell us about your providers, states, and timelines.