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How it works

One plan. A visible path forward.

From the first question to the payer's decision, you can see what has been done, what is next and what needs you.

Payer process
  • PracticeElf agents
  • You
  • Payer
  1. Record Facts and documents organized . PracticeElf agents.
  2. Prepare Application built from your record . PracticeElf agents.
  3. Sign Your authorized person reviews and signs . You.
  4. Submit Sent through a permitted workflow . PracticeElf agents.
  5. Follow up Payer responses tracked and recorded . PracticeElf agents.
  6. Decision Participation and effective date . Payer.

The five steps

  1. Check your fit

    Answer questions about the work, providers, practice, state, payers, timing and readiness. You get an answer for each payer: supported, partially supported, needs review, or unsupported.

    What happens next. If it fits, you can ask for a written scope. If it needs review, a person looks at it first. If it does not fit, you keep the summary as a checklist.

  2. Agree a scope before payment

    The scope lists the providers, payers and work included, what is excluded, and what stays with you. Nothing is charged before you agree it.

    What happens next. Once agreed, your workspace opens with a list of what is needed.

  3. Build the provider record

    You supply facts and documents once. Agents check them against each payer's requirements and flag anything missing or expired.

    What happens next. Missing items appear as actions for you. Preparation starts when the record is complete.

  4. Review and authorize

    Agents prepare applications from the confirmed record. You review the facts. Your authorized person signs and attests and approves which systems may be used.

    What happens next. A prepared application is not submitted until those steps are done.

  5. Follow progress

    Submissions, payer responses and follow-ups are recorded with what was done and when. Waiting on a payer is shown as waiting, not as a problem.

    What happens next. The payer decides on participation and sets the effective date. Your workspace shows both when they arrive.

Your part

What you are responsible for.

The agents do the preparation and follow-up. These decisions and facts stay with you.

  • Give accurate, current information and documents.
  • Tell us when provider or practice details change.
  • Name the authorized person who signs, attests and approves access.
  • Review prepared applications before they are signed.
  • Answer specific questions from us or the payer.

Who does what

One company you deal with, clear roles behind it.

  • CredentialingServices

    Your point of contact. Responsible for the fit check, your scope, your workspace and the customer relationship.

  • PracticeElf

    Runs the agents that prepare and follow up on permitted work, with permissions you approve and a record of every action.

  • Metolius platform

    A separately licensed credentialing platform that holds provider records and workflow.

  • The payer

    Decides on credentialing and participation, and sets the effective date.

Questions about the process.

What happens right after the fit check?

You see a summary you can review and edit, payer by payer. A person then confirms coverage and sends a written scope before any payment.

Can an agent sign for the provider?

No. Required signatures and attestations always stay with the provider or another authorized person. Agents prepare and check, then hand the signature step to that person.

What if a payer takes a long time?

Payers set their own review times. Your workspace shows when the application was submitted, when status was last checked and anything the payer has asked for.

What if something is blocked?

Work stops and you see the reason, the last confirmed action and the next available step. Nothing is resubmitted without a fresh decision.

Start with step one.

See which parts of your request fit, before anything is agreed.

Check your fit