Credentialing Timeline
We’re glad you’re interested in joining us! Here are the basics of our credentialing process and estimated timeframe for each step.
Credentialing process
To get things started, we’ll need you to complete the Provider Request to Participate form and return it to our Credentialing Department. They’ll use the information on this form to add you to our CAQH roster.
Then, CAQH will send you a welcome kit in the mail detailing your next steps.
CAQH will contact you directly with your CAQH Provider ID Number and login instructions for the CAQH Provider Data Portal; this is where you’ll fill out the online Credentialing application.
CAQH then automatically forwards your application back to us within seven days of its completion. The information you enter in CAQH transfers word-for-word into our credentialing software, so please make sure all of your information is complete and accurate.
We will then review your application for compliance with our Credentialing Standards and other criteria. This can take between 14 and 60 days depending on how accurately the application was filled out, how quickly third-party verification data is returned to us, and if we need to contact you for any clarifications.
After this intensive review and verification process, our Credentialing Committee will make an ultimate determination on your application.
You’ll receive a letter from us within 10 days of the Credentialing Committee’s decision. The letter will detail the outcome of your Credentialing Review and provide other important information regarding either claim submission or how to appeal your Credentialing Review decision.
Credentialing timeline
Days 1-7
You submit your participation request to our Credentialing Department. CAQH will then send you a welcome kit in the mail detailing your next steps.
Days 7-14
Using the information from the welcome kit, log in and complete your online application. CAQH will ask that you fax or upload certain documents to complete the application.
Days 14-30
CAQH will send your finished application to us within seven days of its completion. After we get your application from CAQH, it will be queued for processing and review.
Application review period
We review your application and verify all data, schooling, licensure, etc. The more accurate your application data is, the less time it will take our staff to process.
Final steps
If any clarification is needed, we'll try to contact you using the information from your application. Your application will be sent to the next monthly Credentialing Committee meeting.
The number of days used on this timeline are estimations only. Actual processing time can vary based on application completeness and current Credentialing workload.