Credentialing & Enrollment Services in New Mexico

CapitalMed Solutions offers comprehensive credentialing and provider enrollment services for healthcare professionals across New Mexico. Our team ensures timely payer enrollment with New Mexico Medicaid, Medicare, and commercial insurers—reducing denials and improving cash flow.

Why New Mexico Providers Choose Our Credentialing & Enrollment Services

Expertise in New Mexico Medicaid (Centennial Care): Our experts specialize in New Mexico’s Medicaid Managed Care program, Centennial Care, handling provider registration, screening, and revalidation through the New Mexico Medicaid Portal to keep your credentials active and compliant.

End-to-End Credentialing & Contracting: From CAQH, Medicare PECOS, and Centennial Care enrollments to payer contracting, we manage all stages—ensuring quick network access and minimal administrative burden.

Local Expertise Across New Mexico: Whether you practice in Albuquerque, Santa Fe, Las Cruces, Rio Rancho, Roswell, or Farmington, we tailor workflows to meet the specific payer requirements and healthcare standards of your region.

Complete Credentialing Support: From new enrollments and revalidations to updating taxonomy and NPI data, we handle all tasks—license verification, NPDB checks, and follow-ups—so you can focus on patient care.

Credentialing & Enrollment Services We Offer in New Mexico

At CapitalMed Solutions, a trusted medical billing services company, we provide complete credentialing and enrollment support for providers across all specialties in New Mexico.

Whether your needs are national or New Mexico-specific, our experts ensure accurate, compliant, and efficient applications—reducing payer rejections and speeding up reimbursements. As a trusted partner for Medical Billing Services in New Mexico, we help healthcare organizations streamline credentialing and maximize operational efficiency.

Our Credentialing & Enrollment Process in New Mexico

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 New Mexico

  • Faster Payer Enrollment: Streamlined process for Medicaid, Medicare, and commercial payers.
  • 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 New Mexico

We collaborate with all major payer networks to help providers across New Mexico gain and maintain participation efficiently.

humana Credentialing & Enrollment Services in New Mexico
aetna Credentialing & Enrollment Services in New Mexico
Cigna Credentialing & Enrollment Services in New Mexico
United Health Care Credentialing & Enrollment Services in New Mexico
Medicare-Logo Credentialing & Enrollment Services in New Mexico
Molina Healthcare Care Credentialing & Enrollment Services in New Mexico
Medicaid (Centennial Care) Care Credentialing & Enrollment Services in New Mexico
Western Sky Community Care Credentialing & Enrollment Services in New Mexico
Presbyterian Health Plan Credentialing & Enrollment Services in New Mexico
BCBS Credentialing & Enrollment Services in New Mexico

Ready to Simplify Credentialing in New Mexico?

Let CapitalMed Solutions manage your credentialing and enrollment process from start to finish. Our experienced New Mexico team ensures accuracy, compliance, and fast turnaround—so you can focus on what matters most: your patients.

Working Hours

Monday – Friday 09 AM To 05 PM

Our Location

77 Sugarcreek Blvd Suite 600, Sugar Land, TX 77478