Get In-Network Faster
Get Credentialed with Ease
Our assistants take care of every step in the credentialing process, from initial research to follow-ups, ensuring a seamless transition to in-network status. With expert guidance, we streamline the complexities so you can focus entirely on providing quality care without the burden of administrative tasks.
Get In-Network Faster
Get Credentialed with Ease
Our assistants take care of every step in the credentialing process, from initial research to follow-ups, ensuring a seamless transition to in-network status. With expert guidance, we streamline the complexities so you can focus entirely on providing quality care without the burden of administrative tasks.
Now Accepting New Clients!
Commercial Plans
Blue Cross Blue Shield, Aetna, United Healthcare, etc.
Goverment Plans
Medicare, Medicaid, and Tricare
What’s included:
- Introductory meeting (1 hour)*
- Introduction
- Information Gathering
- VA able to respond to questions
- Research by VA to ensure provider is able to credential with insurance panel**
- Credentialing for one insurance panel
- Two (2) follow ups with insurance once completed
- Additional follow ups will be billed at an hourly rate ($45 per hour)
- Access to status reports via spreadsheet
*Additional meetings will be billed at $45 per hour, if requested by the client
**Depending on your licensure, location, etc. you may or may not be eligible to credential with specific insurance panels. If the VA is unable to credential you/your practice due to insurance restrictions, you will be billed at an hourly rate for the research time and meeting.
Credentialing Services
Frequently Asked Questions
How long does credentialing typically take?
This depends solely on the insurance plan. Every insurance is different, the average time for insurance panels accepting new clinicians is 60-120 days. This is not guaranteed!
What information do I need to provide?
- A current professional license in the state you are wanting to be credentialed in.
- Proof of Liability Insurance
- NPI Number – or National Provider Identifier. This is a provision of HIPAA used to identify medical providers.
- Don’t have one yet? Request your NPI here:
https://nppes.cms.hhs.gov/webhelp/nppeshelp/MAIN%20PAGE.html
- Don’t have one yet? Request your NPI here:
- Current resume or CV including employment history for the past 5 years.
- Proof of any special certifications or qualifications
- TAX ID Number – It is recommended that you get an Employer Identification Number (EIN). If you have employees in your practice, this is necessary. And, even if you are a solo practitioner, it can be useful for your practice to have a Tax ID number that is not your Social Security Number. You can apply for this free online through the IRS website.
- Professional references
- Some panels may want a copy of your graduate school transcript
- CAQH Login Information (username and password)
- If you do not have a CAQH set up, sign up here: https://proview.caqh.org/PR/Registration
- This will provide most of the information the VA will need to submit applications
What does it mean if credentialing is taking longer than expected?
Delays can happen due to:
- Insurance panels being backlogged
- Missing or outdated provider information
- Issues with CAQH profiles or expired documents
- Additional verification steps required by insurers
Ensuring that your CAQH profile is updated and attested and all documents are current can help prevent delays.
How do I know when I am officially in-network?
The insurance company will send an official welcome letter and contract confirming your effective date. We track this process and notify you once you’re approved.
Once credentialed, how do I start billing insurance?
Once you’re in-network, you’ll need to enroll in electronic claims processing with the insurance company. Let us assist! Hire one of our administrative VAs to handle the setup process, ensure all necessary paperwork is completed, and guide you through the best practices for smooth and efficient billing.