Credentialing & Enrollment Services in New Jersey
CapitalMed Solutions provides expert provider enrollment and credentialing support for healthcare practices across New Jersey ensuring seamless Medicaid onboarding, compliance, and minimized claim denials.
Why New Jersey Providers Trust Our Credentialing & Enrollment Services?
Statewide Enrollment via NJMMIS Provider Portal: Enrollment whether you’re applying as a physician, dentist, FQHC, or ABA provider—is done through the NJ Medicaid Provider Enrollment applications platform (NJMMIS) via Gainwell Technologies. The portal supports numerous provider types and includes streamlined, consolidated application cover pages for many specialties.
Rigorous Enrollment & Revalidation Process: Providers use NJMMIS to submit new enrollments or revalidation packages, which must include the designated Revalidation Cover Page to be processed. Active status depends on accurate, timely submissions.
Mandatory CMO Provider Approval Under N.J.A.C: Providers delivering Medicaid/NJ FamilyCare through a Care Management Organization (CMO) must first be approved as CMO providers under state regulation N.J.A.C. 10:73‑3.3, including submission of forms like FD‑20, FD‑62, and CMS‑1513. These are processed through the Department of Children and Families before Medicaid enrollment can proceed.
Compliance with 21st Century Cures Act: Following the Cures Act and related mandates, New Jersey requires that all Medicaid providers—including those in managed care—be properly screened and enrolled; claims without Medicaid ID will be denied starting January 1, 2023.
Credentialing & Enrollment Services We Offer in New Jersey
At CapitalMed Solutions, a trusted medical billing service company, we support a wide range of healthcare specialties across New Jersey—including Newark, Jersey City, Paterson, Elizabeth, Trenton, Edison, Toms River, Clifton, Camden, and Union City. 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 New Jersey–specific, our experts stay current to ensure accurate applications, timely follow-ups, and compliant provider enrollment. For each specialty, we deliver tailored credentialing solutions that reduce delays, prevent denials, and streamline your revenue cycle.
Our Credentialing & Enrollment Process in New Jersey
Benefits of Choosing Us for Credentialing Services in New Jersey
Major Insurances Companies
Insurance Networks We Work With for Credentialing in New Jersey
At CapitalMed Solutions, we partner with major insurance carriers across New Jersey 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.
Ready to streamline credentialing in New Jersey?
Connect with our credentialing specialists today let us manage your Medicaid enrollment via NJMMIS, support CMO contract compliance, and expedite your readiness for MCO credentialing so you can focus on delivering exceptional patient care.
Working Hours
Monday – Friday 09 AM To 05 PM
Our Location
77 Sugarcreek Blvd Suite 600, Sugar Land, TX 77478