Credentialing & Contracting

The process of credentialing can be a challenging and lengthy one, and generally takes between 3-4 months to submit the paperwork, submit supplementary documentation, and correspond with insurance companies’ credentialing departments to completion.

  • Perform all aspects of the licensing, credentialing, and appointment process
  • Compiles and maintain current and accurate data for all providers.
  • Complete provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
  • Maintain copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents.
  • Maintain provider contract files.
  • Maintain knowledge of current health plan and agency requirements for credentialing providers.
  • Sets up and maintains provider information in online credentialing databases and system, such as CAQH.
  • Track license and certification expirations for all providers to ensure timely renewals.
  • Ensure new practice address is updated with health plans, agencies and other entities.
  • Tracks license, DEA and professional liability expirations.
  • Audits health plan directories for current and accurate provider information.