How It Works
You hired a provider. They are ready to see patients. But the credentialing process is a black box, the claims are on hold, and nobody can tell you where the file actually is. That is the part most practices hate, and the part we built this page to fix.
The credentialing process is how a provider gets verified and approved to bill in network with payers, from the first document request to the day claims start paying. Here is how we run it for you, what we need from you, and how you will know where things stand.
The credentialing process in 5 steps
We break the work into five stages. The first one is yours and ours together. The rest are ours to drive.
1. Onboarding and document intake
We collect your details and credentials in one pass: licenses, NPI, DEA, CV, board certificates, malpractice proof and your payer list. We tell you up front what is missing, because a gap on day one is what stalls files later. You sign where a form needs it. We handle the rest.
2. Primary source verification and CAQH or PECOS setup
Next we build or update your CAQH ProView profile and attest it, since most commercial payers pull their credentialing data from CAQH. We confirm your NPI in NPPES and, for Medicare, set you up in PECOS with the right CMS 855 form. Primary source verification runs here too, where each credential is confirmed straight from the issuing source rather than from a copy.
3. Payer applications and submission
Then we prepare and file an application to each payer on your list. Medicare, Medicaid and every commercial plan, Aetna, Cigna, UnitedHealthcare, Humana and Blue Cross Blue Shield, has its own forms and portal, so we submit each one to spec the first time. Clean submissions are what keep a file out of the rework pile.
4. Follow up and approval tracking
This is the part that quietly eats months when nobody owns it. We follow up with each payer so your file does not sit in a queue, answer their questions, and push it through the credentialing committee review. When a payer approves you, we confirm your effective date so you know when you can bill.
5. Go live, recredentialing and ongoing maintenance
Once you are loaded in network, you go live and we hand off cleanly to your billing team. Credentialing is not one and done, though. Most payers recredential every two to three years, CAQH has to be reattested every 120 days, and Medicare runs its own revalidation cycle. We track those dates so nothing lapses.
How we keep you in the loop
You should never have to guess where your credentialing process stands. You get a single point of contact and regular written status updates showing each application, its payer, the stage it is in and what is next. If something needs a signature or a document from you, you hear about it early, not after it has held up the file. specific reporting cadence, for example weekly updates status portal or tracking tool name, if one is offered
Prefer to talk it through? Call us and we will walk through your situation. phone
How long the credentialing process takes
Timelines depend on the payer, not on how fast you fill out forms. These are industry typical ranges, framed as typical, not a promise:
Your launch moves at the speed of your slowest payer, usually Medicaid or a backlogged commercial plan. A clean, complete file moves toward the faster end. Any timeline we commit to for your specific engagement, we put in writing. company specific turnaround commitment
For a fuller schedule, see our credentialing timeline and checklist.
What we need from you to start
Onboarding is fast when these are ready. Have them on hand and step one moves the same week:
That is your part. Everything after intake, we own. Want the bigger picture first? Read what medical credentialing is, or see our credentialing services for the full scope.
Frequently asked questions
Ready to get started? Send us your payer list and we will scope your credentialing.
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*ProCred — national medical credentialing and payer enrollment for providers, groups and facilities across the United States.*