Credentialing & Enrollment Services in Texas

CapitalMed Solutions delivers expert provider enrollment and credentialing support across Texas leveraging the PEMS portal, ensuring regulatory compliance, and minimizing claim denials.

Why Texas Providers Trust Our Credentialing & Enrollment Services?

Secure Online Enrollment via PEMS: Texas Medicaid (including CHIP, MTP, LTSS, TVFC, Kidney Health, and more) uses the Provider Enrollment and Management System (PEMS) for all enrollment, re-enrollment, revalidation, and maintenance—no paper applications accepted.

Smart System with Immediate Feedback: PEMS provides real-time error checking and pathways for application updates, resubmissions, and corrections—with access to training materials and helpdesk support.

Risk-Based Screening & Compliance: Enrollment stages include vetting for ownership background, fingerprinting, and potential site visits based on provider risk category.

Revalidation to Stay Active (Typically Every 5 Years): Most providers must revalidate every five years, with some programs requiring more frequent cycles. Timely revalidation is critical to prevent disenrollment and reimbursement delays.

Credentialing & Enrollment Services We Offer in Texas

At CapitalMed Solutions, a trusted medical billing service company, we support a wide range of healthcare specialties across Texas—including Houston, San Antonio, Dallas, Austin, Fort Worth, El Paso, Arlington, Corpus Christi, Plano, and Lubbock. 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 Texas-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 Texas

Assess provider type—individual, group, facility, LTC, etc.—then guide you in setting up your TMHP PEMS account.

Help gather NPI, licensure, ownership data, disclosures, and support materials, then submit electronically via PEMS.

If necessary, manage fingerprinting, site visits, and additional compliance steps following provider risk assessment.

Track submissions, resolve errors flagged in PEMS, and monitor through to approval and provider ID issuance.

Track upcoming revalidation deadlines and facilitate submissions before enrollment expiry, avoiding service interruption.

Support updates through PEMS—including new locations, ownership changes, and data corrections. Blue Cross and other MCOs synchronize enrollment data from TMHP PEMS.

Benefits of Choosing Us for Credentialing Services in Texas

  • Faster Enrollment & Reduced Delays: PEMS streamlines processing with intuitive workflows and immediate feedback.
  • Regulatory Confidence: We ensure compliance with HHSC, TMHP, and CMS requirements including risk-based screening and program specific eligibility.
  • Administrative Relief: From setting up PEMS accounts to submitting documents and tracking approval steps, we manage it end-to-end.
  • Continued Enrollment Security: Excellence in revalidation handling ensures provider status remains uninterrupted and claims process smoothly.
  • Broader Program Access: Once enrolled, you’re ready to provide services across Medicaid, CHIP, LTSS, TVFC, MTP, Kidney Health, and more.

Major Insurances Companies

Insurance Networks We Work With for Credentialing in Texas

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

DMBA Credentialing & Enrollment Services in Texas
Select Health Credentialing & Enrollment Services in Texas
molina Credentialing & Enrollment Services in Texas
humana Credentialing & Enrollment Services in Texas
aetna Credentialing & Enrollment Services in Texas
blue-cross Credentialing & Enrollment Services in Texas
Cigna Credentialing & Enrollment Services in Texas
United Health Care Credentialing & Enrollment Services in Texas
Medicare-Logo Credentialing & Enrollment Services in Texas
Tricare Credentialing & Enrollment Services in Texas

Ready to streamline credentialing in Texas?

Contact our credentialing specialists today we’ll manage your PEMS enrollment, ensure revalidation compliance, handle demographic updates, and prepare your practice for full network readiness so you can focus on delivering outstanding patient care.

Working Hours

Monday – Friday 09 AM To 05 PM

Our Location

77 Sugarcreek Blvd Suite 600, Sugar Land, TX 77478