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Credentialing

Medical Credentialing

Comprehensive credentialing for all kinds of practices and specialties nationwide

Credentialing for Nurses Practitioner

End-to-end nurse credentialing, from smooth application to timely approval

Credentialing Maintenance

Maintenance solutions ensuring full compliance, timely renewals, and error-free documentation

Flexible Credentialing Staffing Solutions

Industry leading staffing for all types of
credentialing

Behavioral Health Credentialing

Professional credentialing for mental health practitioners and counseling providers

CAQH for Providers

Complete your CAQH profile with our personalized, end-to-end assistance

Insurance Credentialing

Verify your credentials for faster insurance enrollment with our credentialing solutions

Value-Added

Value-added allows you to cut down expenses on your administrative needs

Credentialing for Psychologists and Therapists

Provide mental health care with credentialing for psychologists and therapists

Provider Credentialing for Physicians

Provider credentialing and payer enrollment with our credentialing for physicians

Home Care Credentialing

Providing you assistance from agency accreditation to telehealth support

Dental Credentialing

Helps dental professional verify their solo, group, and facility credentials

Pharmacy Credentialing

Strive to be stress-free in enrolling your pharmacy practice to diverse insurance payers

Home healthcare Credentialing

Trusted credentialing for your home health agencies, from OASIS compliance to renewals
Licensing

Medical Licensing

Your licensing journey is guided through systematic process, from application to renewal

Advanced Nurse Licensing

Expand your patient base stress-free through our AN licensing

Medical Licensing (MD/DO)

Keep your practice compliant with our licensing for MD and DO

Physical Therapist Licensing

Easily obtain your PT license through our end-to-end licensing

Telemedicine For Physicians Licensing

Our comprehensive licensing support lets you practice telemedicine with full compliance

Behavioral Health Licensing

Ensure your providers obtain their Behavioral Health license with ease.

Multi-State Licensing Renewal

Our services enable stress-free renewal licenses for your provider nationwide

Physician Assistant Licensing

Obtain your PA license without facing administrative burdens and process delays

Telenurse Licensing

Apply for your license using our comprehensive telenurse licensing

Compact IMLC Licensing

Our compact IMLC licensing let you practice across multiple states

Nurse Licensing for APRN/RN

We handle all your APRN and RN licensing needs, from application to renewal

Telehealth For Behavioral Licensing

Enable telehealth providers for your practice by using our end-to-end licensing solutions.

Nurse Licensing

Serve care and compassion by verifying your license with our end-to-end assistance

CDS Licensing

Stay compliant in prescribing controlled substances with our comprehensive licensing solutions

FCVS Credential Application

Store your credentials in a core repository by easily applying to FCVS

DEA Licensing

Our DEA licensing solutions will make you eligible to prescribe controlled substances
RCM

RCM

Optimize your revenue cycle management with our full RCM

Medical Billing

Learn from the leading billing, from application to reimbursement

Physician Billing

Maximize administrative efficiency for MDs with our physician billing

Hospital Billing

Our hospital billing provide comprehensive billing solutions for healthcare facilities

Charge Entry

Our services help you achieve accurate charge entry that optimizes your revenue cycle

Medical Billing for Small Practices

Help your practice thrive with timely payments and reimbursements

Medical Coding

Eliminate claim denials and rejections with our streamlined medical coding solutions

Payment Posting

Post payments and reimbursements on time with our prompt payment monitoring system

Medical Billing Audit

Our audit services ensures that your billing workflows stay accurate and compliant
Specialties
Anesthesiology

Chiropractic

Endocrinology

Personal Injury

Psychiatry

Emergency Medicine

Family Practice

Gastroenterology

Multi-Specialty

Radiology

Geriatrics

Hepatology

Intensive Care Medicine

Rheumatology

Surgery

Nephrology

Medical Equipment

Ophthalmology

Workers’ Compensation

Cardiology

Dermatology

Hematology

Internal Medicine

Mental Health
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Establish your specialty with accuracy and efficiency

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We attend to your refunds through our prompt processing

Credentialing & Enrollment

Make your practice recognized through our end-to-end solutions

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Blogs

How to Enroll in Insurance Panels as a Mental Health Provider

Read Full Article

How Insurance Credentialing Impacts Mental Health Billing and Reimbursements

Read Full Article
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checklist

Get Your Free Checklist for Your New or Existing Practice!

Launching or growing a medical practice? Whether you’re starting from scratch or expanding an existing provider network, the process can feel overwhelming, but you don’t have to do it alone.

YOUR TRUSTED PARTNER

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Our story

Who We are

At Credex Healthcare, we’ve supported hundreds of healthcare providers in building successful, compliant, and efficient practices. To help you get started on the right path, we’re offering a FREE, expert-crafted Provider Credentialing Checklist — designed specifically for medical practices and providers like you.

This checklist is your step-by-step guide to covering all the essentials from credentialing and payer enrollment to compliance and workflow readiness.

There’s no catch and no obligation, just actionable insights from a trusted partner in healthcare support.

Fill out the quick form, and we’ll send your Free Ultimate Credentialing Checklist right to your inbox.

Credex Healthcare – powering your practice with confidence.

features

What Sets Us Apart

10+ Years

12 Years of Provider / Hospital Credentialing and Enrollment experience

1,000+ Providers

Extensive experience in all 50 states / State regulations / Rules and Compliance

120000+

Over 120,000+ applications successfully filed and contracts received

95%+ Success Rate

95%+ success rate in payer approvals and enrollments.

Checklists

What’s Included in Our Credentialing Checklist

Credentialing can be complex, but it doesn’t have to be. Our all-in-one checklist is designed to simplify the process for both new and existing practices. Whether you’re onboarding a single provider or managing a multi-provider group, this tool ensures you stay compliant, organized, and ready for payer enrollment.

Here’s what you’ll get:

Group & Facility Credentialing Sections

Includes dedicated sheets for group/facility setup, ownership structure, and key operational data essential for enrolling new or expanding practices with payers.

Centralized Login & Access Information Tracker

Keep all system and payer logins, TINs, NPIs, CAQH details, and PECOS information in one secure and editable sheet, making updates and audits faster and easier.

Built-in Status & Remarks Columns

Track which items are completed, pending, or missing. Each row includes a status field so you never lose sight of what’s needed.

Provider Questionnaire Template Included

A structured, easy-to-use form to collect key details directly from providers, speeding up internal coordination and data accuracy.

Designed for ALL Specialties & Practice Types

Whether you’re a solo provider, part of a group, or managing multiple locations, this checklist adapts to your structure and workflows.

Fully Editable & Customizable Excel Format

Download and tailor the checklist to your organization’s internal processes. Use it as a live tracker, onboarding tool, or audit preparation document.

Scenario 1

Established Group - New Provider Credentialing Checklist

Scenario 1: You’re joining an existing group? Here’s what you need to get your credentialing ducks in a row.

Updated and attested CAQH profile

This is your credentialing passport, so make sure it’s current. You’ll need to add your new practice affiliation with your start date. Oh, and if you’re moving states? Don’t forget to update your license and DEA to match where you’ll actually be practicing. Trust me, this oversight causes more headaches than you’d think.

Payer list from your new group

Ask the group to provide their complete contracted payer roster. We’re talking commercial plans, Medicare Advantage, Medicaid HMOs, workers’ comp, Tricare, and any third-party administrators they work with. This isn’t just helpful; it’s essential for knowing where you can actually get paid.

Tax documentation

You’ll need the group’s W9 with their pay-to address plus their CP 575 or 147C letter. These documents get uploaded to CAQH and submitted to insurance companies. Think of them as your financial DNA for credentialing purposes.

Hospital privileges sorted out

Some specialties and payers require hospital credentialing. You’ll need to identify which hospitals you plan to have privileges with in CAQH. No hospital privileges? No problem. Set up an admitting arrangement with another provider nearby, or figure out which hospitalist group or emergency department you’ll partner with for admissions.

Malpractice coverage updated

Either get a new policy or update your current one to include your new employment. This goes straight to CAQH. Here’s the catch: you need to be listed as the named insured on the certificate, not just covered under the group’s blanket policy.

Group’s Type II NPI

You’ll need the group’s primary billing NPI number for applications, along with their tax ID. These two pieces of info are like peanut butter and jelly for credentialing applications.

Medicare PTAN linkage

Get the group’s Medicare PTAN number so you can link in your Medicare application. This connects you to their existing Medicare enrollment.

Required Documentation for Adding New Provider to Existing Practice:

Professional state license
DEA certificate (if applicable) or covering provider name. Quick heads up: If your DEA is from a different state than where you’re applying, you’ll need to transfer it first
CDS certificate (if applicable)
Board certification or proof of board eligibility
Professional liability insurance certificate (must have expiration date more than 60 days in the future throughout the entire credentialing process)
Professional school diploma
Certificates of completion for internships, residencies, and fellowships
CAQH login credentials (if you don’t have CAQH yet, we’ll need: name, date of birth, SSN, home address, and city/state of birth)
PECOS login and password
State Medicaid system credentials (if applicable)
Availity system login, password, and backup codes
Current CV with ALL begin/end dates for education and training listed as EXACT dates (day/month/year), not just month/year. Yes, this level of detail matters.
Hospital admitting privileges or covering provider info. If you have your own privileges, include hospital name, staff status/category (active staff, consulting staff, courtesy staff, etc.), and appointment date.

Scenario 2

New Practice - Provider Credentialing Checklist

Scenario 2: Starting fresh with your own practice? Here’s your roadmap from zero to credentialed.

Establish your group legally

First things first: register your new group in your state. You’ll need to get your tax ID through the IRS, which you can handle online at: https://www.irs.gov/businesses/small-businesses-self-employed/apply-for-an-employer-identification-number-ein-online

Download your CP-575

When you get your EIN, make sure to download the electronic file called CP-575. You’ll need this document repeatedly throughout the credentialing process.

Secure your service address

I know it feels early, but you absolutely need this to complete credentialing. The insurance companies want to know exactly where you’ll be seeing patients.

Apply for your Group NPI

Once you’ve got your business registration, tax ID, and service location nailed down, apply for your Group NPI at: https://nppes.cms.hhs.gov/#/. We can handle this for you if you provide your PECOS/NPPES login credentials. Don’t know them? Call the PECOS/EUS help desk at 866-484-8049 to recover or reset them.

Get your CAQH profile current

Don’t have a CAQH ID or need a refresher on what CAQH actually does? Check out the registration process here: Link The CAQH help desk at 888-599-1771 can help recover and reset your information too.

Map out your payer targets

Identify which insurance companies you want to credential with. Think comprehensive here: commercial PPOs and HMOs, Medicare Advantage plans, Medicaid HMOs, workers’ compensation, Tricare, and any third-party administrators, independent practice associations, or management service organizations active in your area.

Complete your W9

Use your billing/pay-to address, and make sure it reflects your new entity’s information, not your personal details. Download the form here: https://www.irs.gov/pub/irs-pdf/fw9.pdf

Handle hospital credentialing

Some specialties require this, and insurance companies often want to see it during credentialing. At minimum, you need the hospital credentialing process started or have a covering provider, hospitalist group, or emergency department lined up for admissions.

Set up permanent office phone and fax

This number goes in CAQH and on applications, plus it’ll be listed in public directories where patients find you. Using your cell phone or a temporary number you plan to change later? Don’t do it. You’ll just create more paperwork for yourself down the road. Consider solutions like RingCentral or eFax for reliable service.

Secure malpractice insurance

Medicare doesn’t require it, but commercial insurers absolutely do. Pro tip: you can often get a start date that matches when you actually open, so you’re not paying for unused coverage. Just watch out for coverage gaps if your current employer uses a claims-made policy. Upload this policy to CAQH once you have it.

Authorize insurance access in CAQH

When you’re updating and attesting your CAQH profile, don’t forget to check the box authorizing insurance companies to access your profile. This simple step prevents delays.

Gather Medicaid-specific documents

If you’re planning to apply with Medicaid, you’ll need: business license, articles of incorporation, general commercial liability insurance, workers’ compensation insurance, and CLIA certificate or waiver (if applicable).

Start the application process

Once everything’s in place, it’s time to contact payers. Some let you start over the phone (grab that reference number!), others have online portals, and some still want mailed or emailed applications. Medicare applications go through PECOS online, while Medicaid enrollment happens at the state level with different processes for each state.

Required Documentation for Adding New Provider to Existing Practice:

CP 575 or 147C letter
Signed W-9
Business license (if not required in your service area, let us know)
Fictitious name permit (some states don’t require this)
Articles of incorporation or organization (depending on whether you formed an LLC or corporation)
General/commercial liability insurance coverage
Workers’ compensation insurance coverage
CLIA certificate or waiver (if applicable)
EFT verification letter from bank or voided check

Required Documentation for Provider(s) at New Practice:

Professional license
DEA certificate (if applicable) or covering provider name. Important: If your DEA is from a different state than where you’re applying, you need to transfer it first
CDS certificate (if applicable)
Board certification or proof of board eligibility
Professional liability insurance certificate (must have expiration date more than 60 days in the future throughout the entire credentialing process)
Professional school diploma
Certificates of completion for internships, residencies, and fellowships
CAQH login credentials (if you don’t have CAQH yet, we’ll need: name, date of birth, SSN, home address, and city/state of birth)
PECOS login and password
State Medicaid system credentials (if applicable)
Availity system login, password, and backup codes
Current CV with ALL begin/end dates for education and training listed as EXACT dates (day/month/year), not just month/year. Yes, this level of detail matters.
Hospital admitting privileges or covering provider info. If you have your own privileges, include hospital name, staff status/category (active staff, consulting staff, courtesy staff, etc.), and appointment date.

Success Stories

What Our Clients Say

Credex Healthcare handled my whole licensing procedure, from setting up my CAQH to registering my payers, without putting any burden on me. They condensed months of work down to only eight weeks by being clear and talking to each other. We are really happy that our organization is now able to deal with all kinds of clientele.

I was shocked at how hard it was to get multi-state provider licenses. Credex did not have any problems with IMLC, telehealth permits, or state refills. In less than a month, they got me fully licensed in three states, which was precisely what I needed to build my online company.

Since we began utilizing Credex’s RCM services, our cash flow has improved a lot. Their staff helped us collect more money, fixed our code, and stopped us from getting pricey rejections. In just three months, our net sales rose by 20%.

We do things differently now that we work with Credex. They handle billing, licenses, and credentials. We can concentrate on patients instead of paperwork since its “one-point-of-contact” approach and real-time progress updates make it easier to manage back-end tasks.

I’ve partnered with several credentialing firms over the years, but Credex is different. Their U.S.-based team is responsive, detail-oriented, and pushes things forward. They’ve handled Medicaid, private payers, and licensing across states, all without an issue. Highly recommended.

Articles

Recent Blogs

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How Insurance Credentialing Impacts Mental Health Billing and Reimbursements

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Why Credentialing Is Critical for Mental Health Practices to Increase Revenue

Many mental health practitioners across the country continue to choose to run their own private

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