Provider Enrollment

Services FAQ Documentation Links Meet the Team

Welcome to the Provider Enrollment (PE) team! We serve a vital role in ensuring providers are equipped to deliver high-quality care from day one. By coordinating with payers and compliance entities, we work behind the scenes to eliminate delays and ensure every provider is fully credentialed and enrolled.

We’re here to assist with onboarding, as well as ongoing updates to your professional and practice information.

Services

Payor Enrollment Services

Facilitating enrollment with government and commercial payers (Medicare, Medicaid, BCBS, United Healthcare, etc.)
Troubleshooting and resolving issues related to payer enrollment or delays
Managing effective dates and approvals for billing readiness
Processing and verifying provider applications and required documentation
Supporting providers with credentialing portals such as PECOS, NPPES, and others

Ongoing Maintenance & Compliance

Updating provider records for recredentialing, demographic changes, and payer updates
Ensuring compliance with state, federal, and payer requirements for enrollment

Interdepartmental Coordination

Collaborating with departments to gather information needed for successful enrollment
Conduct regular meetings with departments to discuss onboarding status by provider

FAQs:

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How long does the enrollment process take?

Enrollment timelines vary by payer, but typically range from 30 to 90 days from the provider’s credentialed date.
When can I start seeing patients?

Providers must be credentialed before enrollment can be completed. While enrollment with payors is still pending, providers can begin seeing patients as long as no referral or prior authorization is required.
Who do I contact for enrollment questions?

Please visit the Epriv Website to confirm enrollments, if you don’t find what you are needing on the Epriv website, you may contact the Provider Enrollment team at provider.enrollment@utmb.edu for any enrollment-related questions or concerns.
What do I need to submit to begin enrollment?

Please see the “Required Documents” section below for a list of items needed to get started.
How do I update a provider’s practice location, license, or contact info?

Send the update request and supporting documentation to the PE team. We’ll update payer records, internal systems, and notify credentialing if needed.
Who do I contact if I need help with PECOS, NPPES, or other credentialing portals?

The PE team provides support with credentialing portals such as PECOS, NPPES, and I&A. Reach out to us for help navigating these systems.