How Long Does Credentialing Take? What to Do While You Wait

How long does credentialing take? There is no single answer, because each plan sets its own process and queue. A plan will not give you a promise, so the best move is to understand what slows an application down and track it closely. This post explains what you can control and what to do while you wait. For the full process, see our insurance credentialing page.

How long does credentialing take? It depends on the plan

Credentialing means a plan verifies your license, training and coverage before it enrolls you. Each plan reviews files in its own way, and some use a committee. Because of that, the time varies from plan to plan and file to file. Ask each plan how it handles requests and how to check status.

What makes credentialing slower

• Missing or expired documents, such as an old malpractice certificate
• A CAQH profile that is incomplete or not authorized for the plan
• Details that do not match across forms: name, address or Tax ID
• Slow replies to a plan’s follow-up questions
• Plan review cycles you cannot see from the outside

What to do while you wait

• Keep a log: plan, date submitted, application or reference number, and every contact.
• Follow up on a schedule you set, and write down who you spoke to.
• Keep your CAQH Provider Data Portal profile current. See the credentialing terms glossary if a word is new.
• Ask the plan to confirm your effective date in writing once approved.
• Plan your cash flow so you are not counting on insurance payments before you are enrolled.

Can you see insured clients while you wait?

Be careful here. Until a plan confirms your effective date, claims for that plan can be denied. You can see the client as out of network if the plan allows it, or you can wait. Check the rules on in-network vs out-of-network credentialing and our out-of-network therapy billing guide, and use insurance verification before the first visit.

Track your status in one place

Our credentialing and network status page shows how to record the key dates. Use it with our insurance companies contact by state list when you need a plan’s provider line.

Questions to ask the plan

When you ask how long does credentialing take with a specific plan, you will get a better answer if you ask the right questions. Plans differ, and a clear answer helps you plan your schedule and your cash flow.

• Where do I check the status of my application?
• Is there a reference number I should keep?
• Who do I contact if documents are missing?
• How will I be told my effective date?
• Do you require CAQH or your own application?

Plan your cash flow around the wait

Because no one can tell you exactly how long does credentialing take, build a cushion. Do not count on insurance income from a plan until it confirms your effective date. If you are starting a practice, our private practice management resources cover cash flow and billing metrics. The commercial payer glossary entry explains the plan type most clients use.

How MCM South helps

MCM South is a billing company that works only in mental and behavioral health. We serve psychotherapists and psychiatrists in solo and medium-size practices. Our services include credentialing and electronic claims submission. See who we serve.

Credentialing timing FAQ

Where MCM South works

MCM South works only in mental and behavioral health. We serve psychotherapists and psychiatrists in solo and medium-size practices across ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Need a payer contact? Use our insurance companies contact by state directory.