Credentialing and Enrollment Services

Advancing credentialing and enrollment processes to improve healthcare delivery

As credentialing, enrollment, privileging, managed care, and payer contracting continue to evolve, so does their complexity. These processes are essential to delivering timely, high-quality care and helping to ensure accurate reimbursement. With a strong focus on the provider experience, our thought leaders help organizations accelerate onboarding, maintain compliance with state, federal, and payer requirements, and improve revenue cycle performance by minimizing credentialing and enrollment delays and having a sound payer contracting and reimbursement strategy.

BerryDunn’s credentialing consultants help healthcare organizations navigate real-world complexity with confidence. As an NCQA‑certified organization in Credentialing (CR) across all 11 credentialing elements, we deliver independently validated processes and rigorous compliance with regulatory standards. With a decade of certification and perfect scores on our last three surveys, our experts provide practical, scalable solutions that reduce administrative burden and strengthen operational performance.

Credentialing and enrollment services

Our credentialing experts bring a wide range of skills to help you boost efficiency and maintain compliance.

Credentialing services

Provider and payer enrollment services

Payer contracting strategy

Provider privileging

Exclusions and sanctions monitoring

Credentialing services

BerryDunn has the certification, systems, workflows, policies, and team in place to verify your providers’ credentials thoroughly and accurately. As an NCQA-certified organization, we help clients increase operational effectiveness with strict adherence to compliance policies and regulatory standards.

Primary Source Verification
(PSV) services

We provide services for delegated commercial payer agreements and internal privileging processes.

Continuous monitoring
services

We monitor state and federal exclusion lists, as well as license suspensions and malpractice settlements.

Outsourced MSO
services

Our team has the depth of expertise to manage your Medical Staff Office (MSO) temporarily or over the long-term.

Provider and payer enrollment services

Our comprehensive provider, group, and facility enrollment services are designed to streamline operations and ensure regulatory and payer compliance. From application completion to maintenance activities (CAQH, PECOS, NPPES, etc.) and revalidations to change of ownership and information submissions, we have scalable solutions for organizations of all sizes.

Payer contracting strategy

We help organizations develop and manage payer contracts that support growth, access, and financial sustainability. From evaluating network participation and reimbursement terms to aligning contracting strategies with credentialing and enrollment timelines, our team helps you make informed decisions that strengthen payer relationships and support long-term revenue goals.

Provider privileging

BerryDunn can complete, submit, and track privileging applications for providers to render services at organizations including health systems and hospitals, Federally Qualified Health Centers (FQHCs), and Ambulatory Surgery Centers (ASCs). We help organizations develop and operationalize credentialing and privileging processes.

Exclusion and sanctions monitoring

We equip organizations with resources to manage credentialing, revenue, and compliance risks by performing continuous monitoring of federal exclusion lists. These monitoring activities help our clients comply with federal mandates prohibiting healthcare organizations from hiring or doing business with excluded or sanctioned individuals and entities.

Credentialing solutions built for speed, compliance, and scale

We help healthcare organizations remove obstacles that delay onboarding, strain staff, and introduce compliance risk while building efficient, sustainable operations.

Faster provider onboarding

We address enrollment and credentialing backlogs that delay providers from seeing patients by using proven workflows, technology, and dedicated specialists to keep applications moving and timelines on track.

Supplemental credentialing support

We work alongside your team to help manage workload fluctuations, bringing specialized expertise to keep credentialing activities moving efficiently.

Compliance confidence

We help mitigate compliance concerns related to NCQA standards and payer requirements with strict adherence to policies, detailed documentation, and ongoing quality controls at every step.

Streamlined workflows

Outdated or inefficient processes slow credentialing timelines. We assess and improve workflows to reduce manual steps, eliminate bottlenecks, and improve overall operational effectiveness.

Ongoing monitoring and oversight

Managing exclusion monitoring and continuous compliance can be complex. As an NCQA-certified organization, we use established systems and controls to ensure accurate verification and continuous oversight.

Best practices and sustainability

We help organizations navigate managed care strategy and payer contracting with a growth-focused approach, providing the analysis and guidance you need to make informed operational decisions.

Credentialing consulting services

Through our first-hand experience as an NCQA-certified CR serving clients across the continuum of care, we offer a variety of strategic credentialing, enrollment, and payer contracting consulting services to meet your organization’s specific needs.

Our depth and breadth as an organization allow us to partner with you across the full provider life cycle—from revenue cycle, service line assessments, and delegation and NCQA readiness to workflow design and departmental structure. We also bring deep experience supporting organizations through change of ownership, affiliation, and merger and acquisition activities, helping manage the complex credentialing, enrollment, payer contracting, and data transition requirements that accompany these shifts.

Meet our professionals

Susan Prior

Christa Bernacchia

Gretchen Carletta

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Industries we serve

Industry

Hospitals

Industry

Medical and Dental Practices

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Long-Term Care, Assisted Living and Senior Living

Industry

Community Health Centers and Rural Health Clinics

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Podcast

The Alphabet Soup of Accreditation, Credentialing, and Privileging

As an NCQA-certified Credentials Verification Organization (CVO), we assist our clients by streamlining the process with strict adherence to compliance policies.

Achieving CVO certification from NCQA demonstrates that we have the systems, processes, and personnel in place to thoroughly and accurately verify your providers’ credentials.