Credentialing & Enrollment Services in Vermont

CapitalMed Solutions offers end-to-end credentialing and provider enrollment services for healthcare professionals across Vermont. From Medicaid and Medicare to major commercial payers, we ensure every step of the credentialing process is handled with precision, reducing denials and speeding up reimbursements.

Why Vermont Providers Choose Our Credentialing & Enrollment Services

Expertise in Vermont Medicaid (Green Mountain Care): Our specialists manage Vermont’s Medicaid enrollment through the Gainwell Provider Portal—handling provider applications, screenings, revalidations, and ongoing compliance to keep your credentials current.

End-to-End Credentialing & Contracting: We oversee everything from CAQH and Medicare PECOS registrations to Vermont Medicaid and private payer contracting—ensuring fast, error-free network participation.

Local Expertise Across Vermont: Whether your practice is in Burlington, South Burlington, Rutland, Barre, Bennington, or Montpelier, we tailor workflows to your region’s payer network requirements and state regulations.

Complete Credentialing Support: From initial enrollments to revalidations, our team manages taxonomy and NPI updates, NPDB checks, and payer follow-ups—so you can focus on quality patient care.

Credentialing & Enrollment Services We Offer in Vermont

At CapitalMed Solutions, a trusted medical billing services company, we provide customized credentialing and enrollment solutions to all healthcare specialties across Vermont.

Whether your needs are national or Vermont-specific, our experts ensure all applications are accurate, compliant, and processed on time—reducing payer rejections and accelerating your revenue cycle. As a trusted partner for Medical Billing Services in Vermont, we help practices simplify credentialing and boost reimbursement efficiency.

Our Credentialing & Enrollment Process in Vermont

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 Vermont

  • 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 Vermont

We collaborate with leading insurance carriers across Rhode Island to help providers gain network participation efficiently and maintain compliance.

humana Credentialing & Enrollment Services in Vermont
aetna Credentialing & Enrollment Services in Vermont
Cigna Credentialing & Enrollment Services in Vermont
United Health Care Credentialing & Enrollment Services in Vermont
Medicare-Logo Credentialing & Enrollment Services in Vermont
Northeast Delta Dental Credentialing & Enrollment Services in Vermont
Vermont Managed Care (VMC) (Green Mountain Care) Credentialing & Enrollment Services in Vermont
Vermont Medicaid (Green Mountain Care) Credentialing & Enrollment Services in Vermont
MVP Health Care Credentialing & Enrollment Services in Vermont
BCBS Credentialing & Enrollment Services in Vermont

Ready to Simplify Credentialing in Vermont?

Let CapitalMed Solutions take the hassle out of credentialing. Our Vermont experts ensure fast, compliant, and accurate provider enrollment with all major payers.

Working Hours

Monday – Friday 09 AM To 05 PM

Our Location

77 Sugarcreek Blvd Suite 600, Sugar Land, TX 77478