NewBecker's 2026 Top RCM · Inc. 5000 · Dallas 100
One ASC cut aged A/R from $4.55M to $0.76M in nine months →
SOC 2 Type 2 · HIPAA · BHCOE · CASP
AI-powered provider enrollment, payer credentialing, and ongoing credentialing management that keeps your providers billing without interruption. Plutus Health combines 15+ years of provider credentialing expertise with Credentialing AI to manage enrollment, CAQH maintenance, payer submissions, roster management, demographic updates, and re-credentialing in a single connected workflow.
Get Your Free RCM Assessment→Getting providers credentialed quickly requires far more than submitting forms. Every payer follows different enrollment rules, document requirements, processing timelines, and follow-up workflows. We combine automation with experienced enrollment specialists to keep applications moving until providers are approved and ready to bill.
We prepare and submit complete enrollment applications for individual providers, groups, and facilities while tracking every payer requirement from submission through approval.
We create, update, attest, and continuously maintain CAQH profiles so that applications never stall due to incomplete or expired information.
Commercial, Medicare, Medicaid, and managed care enrollments are handled using payer-specific workflows rather than generic submission processes.
Every provider affiliation, Tax ID, Billing NPI, Rendering NPI, and location is maintained accurately across payer systems.
Claims, remittance advice, and electronic payments are configured alongside credentialing to avoid unnecessary billing delays.
Licenses, DEA registrations, malpractice insurance, board certifications, and supporting documents are monitored continuously to prevent enrollment interruptions.
The Credentialing AI agent continuously monitors CAQH profiles, provider documents, payer portals, enrollment status, roster updates, and re-credentialing deadlines.
Organizations typically reduce enrollment timelines from the traditional 90 to 120 days to a median of 45 to 60 days for standard credentialing workflows.
Routine monitoring, reminders, document tracking, and status polling run automatically. We handle complex payer negotiations, enrollment exceptions, and unique state requirements with experienced credentialing specialists.
Instead of checking dozens of payer portals manually, our AI monitors credentialing activity around the clock, flags missing information immediately, and routes exceptions to credentialing experts before delays affect reimbursement.
We collect provider, practice, and facility information using a structured credentialing checklist.
Every credential is validated before submission to reduce payer rejections.
Profiles are created, completed, verified, and maintained with ongoing attestations.
Applications are prepared according to each payer's enrollment requirements instead of generic templates.
Credentialing specialists communicate directly with payers until enrollment is complete.
Credentialing doesn't stop after approval. We manage renewals, demographic updates, provider changes, and ongoing enrollment maintenance throughout the provider lifecycle.
Real-Time Visibility
Every application, payer response, document request, and enrollment milestone is available through one centralized credentialing workflow.
Most credentialing vendors stop once providers are enrolled.
We continue managing the activities that protect reimbursement long after approval, including:
Your providers remain credentialed, compliant, and continuously ready to bill.
30 days diagnostic baselines your current credentialing performance against MGMA/HFMA medians and shows you the agent-driven to-be model.
