Short answer: Start credentialing at least 90 to 120 days before a provider's first patient. Collect licenses, DEA, board certification, malpractice and work history, complete CAQH, enroll in Medicare through PECOS and submit commercial applications, then follow up weekly until each payer confirms an effective date.
Documents to collect
- State medical license(s) and DEA registration
- Board certification and education history
- Current CV with month and year dates, explaining any gaps over six months
- Malpractice insurance certificate and claims history
- NPI (individual and group), tax ID and W 9
- Hospital privileges or admitting arrangements
- Government issued ID and, where required, CLIA certificate
Steps and timelines
| Step | Typical time |
|---|---|
| Collect documents and verify NPI | Days 1 to 3 |
| Complete or update CAQH ProView and attest | Week 1 |
| Medicare enrollment through PECOS (855I and 855R) | Often 30 to 60 days |
| State Medicaid enrollment | 30 to 90 days, varies by state |
| Commercial payer applications | 60 to 120 days |
| Contract signature and effective date confirmation | On approval |
Common delays
- CAQH not attested or missing documents.
- Unexplained gaps in work history.
- Practice location or group NPI not matching across applications.
- No weekly follow up, so applications sit unassigned in payer queues.
Our credentialing team submits within 48 hours of receiving documents and follows up with every payer weekly.
