Credentialing & EDI Services Seamless Payer Connectivity Across the USA
Access. Automation. Assurance.
At Miami RCM, our Credentialing & EDI Services are designed to simplify and accelerate your practice’s onboarding and payment processes. We handle payer credentialing (commercial & government) to ensure you’re enrolled with the necessary insurance networks quickly and accurately. To maintain uninterrupted operations, we also offer complete re-credentialing support, tracking expiration dates and managing renewals on your behalf.
Our team manages seamless EDI enrollment & setup, allowing electronic claims submission, eligibility verification, and faster communication with payers. To further improve efficiency, we provide EFT & ERA integration, so payments and remittance advices are directly deposited and reconciled automatically.
Our Credentialing & EDI Services Include
Payer Credentialing (Commercial & Government)
We handle end-to-end credentialing with both commercial insurance companies and government payers like Medicare and Medicaid. From application submission to ongoing communication
Re-Credentialing Support
Avoid interruptions in reimbursement due to expired credentials. Our team monitors re-credentialing timelines and manages renewals proactively to keep your contracts active and compliant.
EDI Enrolment & Setup
We facilitate Electronic Data Interchange (EDI) enrolment, Electronic funds transfer (EFT), Electronic remittances (ERA), enabling you to submit claims electronically, check patient eligibility in real-time, and receive faster processing from payers.
Why Choose Miami RCM’s Credentialing & EDI Support Experts?
Faster enrollments. Seamless connections. Zero guesswork.
Credentialing and EDI setup shouldn’t slow you down—and with Miami RCM, it won’t. We streamline provider enrollments, payer registrations, and electronic data interchange (EDI) connections with precision and persistence. Our team navigates the red tape so you don’t have to, ensuring every credentialing packet is complete, compliant, and submitted on time.From solo providers to multi-location groups, we tailor credentialing workflows to your structure and specialty. And once you’re enrolled, our EDI experts ensure clean, secure data transmission—so claims flow faster, eligibility checks run smoother, and your systems stay in sync.
With Miami RCM, you gain more than support—you gain a proactive partner who clears the path for growth.
Complete Payer Credentialing (Commercial & Government)
We handle all credentialing processes with Medicare, Medicaid, and private insurers to ensure you're authorized to bill accurately.
Reliable Re-Credentialing Support
Our team tracks deadlines and submits renewals on time to prevent disruptions in reimbursement or payer participation.
Seamless EDI Enrolment & Setup
We enrol your practice in electronic systems for faster claims submission, eligibility checks, and secure communication with payers.
Fast EFT & ERA Integration
Get paid faster with electronic funds transfer and remittance advice directly into your system for easy reconciliation.
Compliance-Driven Process
We follow strict guidelines to ensure your credentialing and EDI setup meet payer and regulatory standards.
Payer Credentialing (Commercial & Government)
Accelerating provider enrollment with precision, compliance, and payer-specific expertise.
Credentialing delays can stall revenue and disrupt patient care—but Miami RCM streamlines the process from start to finish. We manage commercial and government payer enrollment with meticulous attention to detail, ensuring your practice is credentialed correctly, quickly, and compliantly. Our team handles the paperwork, follows up with payers, and keeps you informed every step of the way.
Our approach includes:
Revalidation and re-credentialing management to ensure uninterrupted billing
Customized credentialing workflows aligned with dermatology practice needs
Application tracking and proactive follow-ups to reduce turnaround time
Enrollment support for Medicare, Medicaid, and top commercial payers
Ongoing updates on payer policies and enrollment requirements
CAQH profile setup and maintenance
Ensures full access to insurance networks.
Reduces rejections and delays in approval
We handle every step—from initial application to final approval.
Quicker enrollment means quicker payments for your services.
Re-Credentialing Support
Protect your revenue with proactive re-credentialing that keeps your payer status current and uninterrupted.
Expired credentials can lead to denied claims and billing disruptions. Miami RCM ensures timely re-credentialing for both commercial and government payers, managing deadlines, documentation, and compliance updates so your practice stays fully enrolled and operational. We monitor revalidation cycles and handle renewals with precision—so you never miss a beat.
Our approach includes:
Automated tracking of re-credentialing deadlines and payer requirements
Alerts for upcoming expirations to prevent billing interruptions
Complete documentation management and submission
Follow-ups with payers to confirm revalidation status
Compliance alignment with evolving payer policies
CAQH updates and profile maintenance
EDI Enrolment & Setup
Enable faster, error-free claims processing with expert EDI configuration and payer integration.
Electronic Data Interchange (EDI) is the backbone of efficient healthcare billing—but setting it up can be complex. Miami RCM simplifies EDI, Electronic funds transfer (EFT), Electronic remittances (ERA) enrollments and configuration for both commercial and government payers, ensuring seamless data transmission, compliance with HIPAA standards, and reduced claim rejections. From initial setup to ongoing support, we make sure your systems are connected, secure, and ready to scale.
Our approach includes:
Support for ERA (Electronic Remittance Advice) and EFT (Electronic Funds Transfer) setup
EDI enrollment with Medicare, Medicaid, and major commercial payers
Secure transmission setup for claims, remits, and eligibility checks
Ongoing monitoring and troubleshooting of EDI file transmissions
Clearinghouse coordination and payer-specific configuration
Compliance with ANSI X12 and HIPAA transaction standards
Receive payments electronically, without waiting for checks.
Auto-post ERA data directly to your billing system.
Eliminate manual payment posting and data entry.
Track incoming revenue in real-time for better forecasting
We ensure full HIPAA and payer compliance during integration.
Ready to Simplify Your Revenue Cycle?
Frequently Asked Questions
Your practice’s success is our priority. Here’s how we deliver results with speed, transparency, and precision.
We offer flexible pricing based on the volume and complexity of services performed. Our rates typically range between 2% to 5% of collections, ensuring you only pay for the value we deliver.
We complete billing and coding within 24 hours from the date of service—provided medical records are available. Our speed in processing directly boosts your revenue flow and minimizes delays.
We maintain a 90+ Accounts Receivable (AR) at just 15% on average, and keep Days in AR around 30 days. This reflects our commitment to efficient collections and clean claims management.
Absolutely. We share standard performance reports regularly to help you monitor key metrics. Need custom analytics? We can tailor reports to your specific business goals—empowering smarter decisions and better outcomes.
Yes, Miami RCM LLC is fully HIPAA compliant. We prioritize the confidentiality, integrity, and security of patient data through:
– Encrypted data transmission and storage
– Role-based access controls
– Regular audits and compliance checks
– Secure cloud infrastructure
Our team is trained in HIPAA protocols, and we continuously update our systems to meet evolving regulatory standards—so your data stays protected, always.
Not at all. We adapt to your existing EHR/PM system seamlessly. If needed, we can also recommend more efficient platforms tailored to your workflow and specialty—but the choice is always yours.
You get 24×7 support through direct phone calls and emails from our expert team. We take customer queries seriously and respond promptly—because your peace of mind matters as much as your revenue.
