Credentialing & Enrollment Services in California

CapitalMed Solutions delivers comprehensive provider enrollment and credentialing services customized for healthcare practices across California—streamlining your revenue cycle and minimizing claim denials.

Why California Providers Rely on Our Credentialing & Enrollment Services?

Expert in Medi‑Cal (California Medicaid) Enrollment: We handle applications via the DHCS Provider Enrollment Division (PED) and use the electronic PAVE portal to enroll in Medi‑Cal Fee‑for‑Service programs—ensuring accuracy and faster approvals.

Complete Credentialing Process from Start to Finish: From CAQH profile creation and PECOS Medicare enrollment to Medi‑Cal submissions and private payer paneling—our team manages it all, including primary source verifications and NPDB checks.

Navigating California’s Managed Care Landscape: We facilitate credentialing and enrollment into Medi‑Cal Managed Care Plans (MCOs), working with systems regulated by the California Department of Managed Health Care (DMHC)—especially important when serving diverse markets across counties.

Wide Statewide Expertise : Whether you’re in Los Angeles, San Francisco, San Diego, Sacramento, Fresno, Oakland, or San Jose, our services adapt to the unique insurance networks and regulatory nuances of each region.

Credentialing & Enrollment Services We Offer in California

At CapitalMed Solutions, a trusted medical billing service company, we support a wide range of healthcare specialties across California—including Los Angeles, San Diego, San José, San Francisco, Fresno, Sacramento, Long Beach, Oakland, Bakersfield, and Anaheim. Our specialty credentialing and payer enrollment services cover anesthesiology, radiology, cardiology, orthopedics, primary care, pediatrics, and more—helping practices statewide gain network participation efficiently.

Whether requirements are national or California-specific, our experts stay current to ensure accurate applications, timely follow-ups, and compliant provider enrollment. As a trusted Medical Billing Services Company in California, we deliver customized credentialing solutions for each specialty—reducing delays, preventing denials, and streamlining your revenue cycle.

Our Credentialing & Enrollment Process in California

Identify provider type (individual, group, FQHC, clinic) and determine enrollment pathways—Medi‑Cal FFS via PED/PAVE or Managed Care Plans.

Gather NPI, CA license, W-9, malpractice proof, and set up CAQH and PECOS profiles.

Submit applications via PAVE for Fee-for-Service Medi-Cal, and to MCOs as required.

Conduct primary source verification, monitor application status, and respond to DHCS or plan feedback.

Confirm Medi-Cal and MCO paneling, provider IDs, and enable EFT or EDI billing setup.

Manage periodic revalidations, CAQH attestations, and portal updates to maintain billing capability.

Benefits of Choosing Us for Credentialing Services in California

  • Faster Enrollment & Reimbursement: Navigating PED and PAVE with precision accelerates reimbursement timelines.
  • Reduced Administrative Hassle: Outsource complex credentialing tasks and allow your team to focus on patient care.
  • Regulatory Compliance: We stay current with DHCS, DMHC, and Medi-Cal managed care rules.
  • Seamless Managed Care Access: Panel with Medi-Cal FFS and key MCOs across counties—from the Bay Area to L.A., the Central Valley to San Diego.
  • Stronger Financial Stability: Credentialed status ensures clean claims and smoother cash flow.

Major Insurances Companies

Insurance Networks We Work With for Credentialing in California

At CapitalMed Solutions, we partner with major insurance carriers across California to ensure seamless provider credentialing and faster payer enrollment. Our strong relationships with leading payers help healthcare professionals get credentialed efficiently, stay compliant, and serve more patients with confidence.

LACHP Credentialing & Enrollment Services in California
Health Net Credentialing & Enrollment Services in California
Blue Shield Credentialing & Enrollment Services in California
BCBS Credentialing & Enrollment Services in California
Molina Credentialing & Enrollment Services in California
humana Credentialing & Enrollment Services in California
aetna Credentialing & Enrollment Services in California
Cigna Credentialing & Enrollment Services in California
United Health Care Credentialing & Enrollment Services in California
Medicare-Logo Credentialing & Enrollment Services in California

Ready to simplify credentialing in California?

Reach out to our credentialing specialists today—let us streamline your Medi-Cal and Medicare (PECOS), secure payer paneling, and minimize denials across California’s complex healthcare landscape.

Working Hours

Monday – Friday 09 AM To 05 PM

Our Location

77 Sugarcreek Blvd Suite 600, Sugar Land, TX 77478