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Credentialing services
in Manhattan, NY
Qualigenix credentialing services enroll Manhattan providers with Medicaid, Medicare and commercial plans, keep CAQH current and track every application until the payer decides. Pricing is $99 per payer application.
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How Qualigenix serves Manhattan practices
Qualigenix credentials Manhattan providers who usually need a long list of separate approvals before their first full schedule. A new physician joining a Manhattan group may need New York Medicaid enrollment, Medicare enrollment, credentialing with several Medicaid plans and contracts with commercial carriers, each on its own timeline. Every one of those files starts with a current New York license, registered with the State Education Department's Office of the Professions, where physicians re-register every two years. The statewide steps, from Medicaid enrollment to license verification, are on our credentialing services in New York page. This page covers the Manhattan side: which plans review your providers and where applications stall. We track every application in one place and report status by payer.
What credentialing services does Qualigenix provide in Manhattan?
Qualigenix handles individual and group credentialing, Medicaid enrollment and revalidation, Medicare enrollment, CAQH profile management, re-credentialing and application follow-up for Manhattan practices. That includes credentialing with each of New York County's seven Medicaid managed care plans and three HIV Special Needs Plans, which review providers separately.
Claims are scrubbed and tracked across all major commercial and government payers in New york.
Credentialing for New York County's Medicaid plans
Qualigenix credentials Manhattan providers with every Medicaid plan their patients use. New York Medicaid requires enrollment for every provider who treats Medicaid members, including providers who only see managed care patients and those who appear on claims as ordering, referring or attending providers. Plan credentialing comes after that enrollment, plan by plan.
Seven mainstream plans
State Department of Health listings show seven mainstream Medicaid managed care plans in New York County: Anthem Blue Cross and Blue Shield HP, EmblemHealth, Fidelis Care, Healthfirst, MetroPlusHealth, Molina Healthcare and UnitedHealthcare. Each runs its own credentialing review and its own provider contract, and most also offer HARP behavioral health products. Qualigenix submits to each plan your practice wants to join and tracks every file until the plan decides.
HIV SNP networks
Amida Care, MetroPlusHealth Partnership in Care and SelectHealth from VNS Health are New York City's three HIV Special Needs Plans. Each keeps its own provider network. Practices that treat many SNP members need participation with each plan, and Qualigenix handles those applications along with the mainstream plans.
Statewide Medicaid enrollment
New York moved all Medicaid enrollment and revalidation to the online Provider Services Portal and stopped accepting paper in May 2026. Every enrolled provider must revalidate within the next 24 months, and a new enrollment started in the portal has to be submitted within 45 days or it's withdrawn. New enrollments are also paused for labs, medical equipment suppliers, ABA providers, home care agencies, pharmacies and long-term care plans. Qualigenix handles that work for Manhattan providers the same way it does statewide, as covered on our New York credentialing page.
RESULTS ACROSS 275+ PRACTICES
Results Manhattan practices can expect
Qualigenix reports credentialing status the same way for every client. The figures below are company-wide, not Manhattan-only.
12K+
Credentialing contracts managed
99%
Submission to approval
To NCQA and CMS standards
Primary source verification
Managed on a 90-day cadence
CAQH re-attestation
Per payer
Status reporting
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ ClinicsGETTING STARTED
How onboarding works
Qualigenix credentials Manhattan providers in eight steps.
01
Provider data collection
Licenses, board certifications, malpractice history and work history for each provider.
02
Primary source verification
Primary source verification to NCQA and CMS standards.
03
CAQH profile setup
CAQH ProView profile set up or updated, then re-attested on a 90-day cadence.
04
Payer applications filed
Payer applications filed with Medicaid, Medicare and each commercial and Medicaid plan you choose.
05
Network participation confirmed
Contracts and network participation confirmed with each plan.
06
Application follow-up
Follow-up on every open application until the payer decides.
07
Re-credentialing tracked
Re-credentialing and revalidation tracked from the first approval.
08
Per-payer status reports
Status reported for each payer, so you know which plans you can bill.
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WHY PRACTICES CHOOSE QUALIGENIX
Why Manhattan practices choose Qualigenix
Independent clinics and specialty practices in Manhattan trust Qualigenix for dedicated claim support.
$99 per application
Qualigenix charges $99 per payer application. You know the cost of each enrollment before it starts.
One dedicated specialist
Every Manhattan account gets one named specialist who knows your providers, your plans and where each file stands.
Per-payer status reports
You see each application's status by payer. When a provider can start billing a plan, you know the same day.
HAVE QUESTIONS?
Frequently Asked Questions
Frequently asked questions about our setup and support in Manhattan.
Yes. Qualigenix credentials providers with all seven mainstream Medicaid managed care plans in New York County and the three HIV Special Needs Plans. New York Medicaid enrollment comes first, and we handle that too. Tell us which plans you want to join.
New York now handles Medicaid enrollment and revalidation only through its online Provider Services Portal, and every enrolled provider must revalidate over the next 24 months. Providers get 123 days after a notice to finish. Qualigenix files each revalidation and confirms it's complete.
Yes. Qualigenix enrolls Manhattan providers in Medicare through PECOS with National Government Services and completes benefit assignment. We track revalidation dates after approval.
Yes. Qualigenix sets up and updates CAQH ProView profiles and re-attests them on a 90-day cadence, ahead of the 120-day requirement. Your profile never lapses mid-application.
Qualigenix works within a 45-90 day payer approval window and follows up weekly or biweekly on every application. Payers make the final decision. New York requires commercial plans to respond within 60 days of a completed application.
Qualigenix charges $99 per payer application, covering full provider credentialing and payer enrollment. A credentialing specialist can total the cost for your plan list.
No. What matters is whether the team knows the plans your providers need to join: New York Medicaid, seven county plans, three HIV Special Needs Plans, NGS and commercial carriers. Qualigenix handles all of them. Book a meeting to map your plan list.