What is provider enrollment?
Provider enrollment is the process of registering a credentialed provider with insurance payers — commercial plans, Medicare, and Medicaid — so the provider is in-network and claims can be reimbursed. MMSM handles enrollment applications, group and location linkage, EFT/ERA setup, and ongoing revalidations for Michigan providers, preventing the gaps that cause denied or unpayable claims.
In-network is where you get paid
You can be perfectly credentialed and still not get paid — because credentialing only proves you’re qualified. Enrollment is what actually puts your providers into each payer’s network and links them to your billing group. Get a single detail wrong — a group linkage, a PECOS record, a revalidation date — and claims start bouncing for reasons that are maddeningly hard to diagnose.
MMSM manages enrollment as a discipline, not an afterthought. We submit complete applications, link providers correctly to your group and locations, set up electronic payments, and keep a calendar of every revalidation so your enrollment never quietly lapses.
What we manage
- Commercial payer enrollment for the plans your patients actually carry
- Medicare enrollment through PECOS
- Michigan Medicaid (CHAMPS) enrollment
- Group and location linkage so claims route and pay correctly
- EFT/ERA setup for faster electronic payment and reconciliation
- Revalidation and ongoing maintenance
Because enrollment connects directly to credentialing and billing, keeping it all under one MMSM roof eliminates the finger-pointing that happens when three different vendors each blame the other for a denied claim.
Get your providers enrolled or call (517) 485-0001.
What's included
- Commercial, Medicare (PECOS) & Medicaid enrollment managed end to end.
- Group & location linkage so claims route and pay correctly.
- EFT/ERA setup for faster electronic payments and remittance.
- Revalidation tracking to prevent costly enrollment lapses.
- CAQH coordination kept in sync with your credentialing.
- Application status reporting for every payer, every provider.
