Credentialing Maintenance
You got credentialed.
Unfortunately, credentialing didn’t end there.
Getting approved by an insurance company feels like it should be the finish line.
And for a little while, it is.
Then your license renews.
Your address changes.
CAQH wants ANOTHER re-attestation.
A payer asks for updated malpractice insurance.
Medicare wants something.
Someone joins your group.
Someone leaves your group.
And eventually an insurance company sends you a letter that somehow manages to be both incredibly important and incredibly unclear.
Welcome back to credentialing.
First, let’s talk about what maintenance actually means.
Credentialing isn’t something you complete once and never think about again.
Your information lives across multiple systems, payers, portals, and enrollment records, and some of those places need attention when something changes.
You can absolutely manage this yourself.
Keep a credentialing tracker.
Know which payers you’re enrolled with.
Keep CAQH current.
Track your documents.
Read payer notices.
Update information when something changes.
And keep records of what you submitted, when you submitted it, and preferably some proof that you actually submitted it.
If you’re organized and have the time to stay on top of it, wonderful.
You may not need me.
But if credentialing has become one more thing sitting on your administrative list…
That’s where Credentialing Maintenance comes in.
This service is for clinicians and group practice owners who want ongoing help keeping their existing credentialing information organized and current.
Instead of waiting until something goes wrong, we maintain things along the way and address updates as they come up.
What this can include:
- Maintaining and updating CAQH profiles
- Completing CAQH re-attestations
- Updating credentialing information after license renewals
- Maintaining current provider demographic and practice information
- Assisting with payer demographic changes
- Tracking payer credentialing requirements
- Monitoring Medicare or Medicaid revalidation needs, when applicable
- Helping respond to requests for updated credentialing information
- Organizing credentialing records and supporting documentation
- Coordinating applicable credentialing updates for group practice clinicians
- Identifying credentialing discrepancies that need attention
- Helping resolve routine credentialing issues before they turn into bigger ones
And because I know what you’re thinking…
No, “maintenance” does not mean unlimited credentialing for every insurance company you’ve ever heard of.
There is a difference between maintaining an existing credential and applying for a brand-new one.
If you’re already credentialed with a payer and information needs to be maintained or updated, that may fall under Credentialing Maintenance.
If you decide tomorrow that you’d like to join three new insurance panels, that’s new credentialing.
Different project.
Different service.
Same person helping you, but we’re keeping some boundaries here.
What if I only need reminders?
Then you probably don’t need Credentialing Maintenance.
I also offer Credential Tracking & Renewals for $50 per year, per clinician.
You provide your important credentialing dates and documents, I help maintain the documents you’ve provided and remind you when something is coming due.
You handle the actual updates.
It’s intentionally simple.
If you want someone more involved in maintaining the credentialing itself, that’s when this service makes more sense.
The goal is simple.
Current information.
Organized records.
Fewer credentialing surprises.
And ideally, fewer moments where you discover a problem because claims suddenly stopped paying.
Pricing
Credentialing Maintenance is priced based on the number of clinicians, payers, and the level of ongoing support your practice needs.
We’ll look at your current credentialing setup first and determine what actually needs to be maintained.
I’m not going to sell you a giant credentialing package if what you really need is someone to re-attest CAQH and remind you your malpractice insurance expires in October.
Ready to get credentialing off your ongoing administrative list?
We’ll start by looking at where you’re currently credentialed, what needs regular maintenance, and what’s currently living in your head, inbox, spreadsheet, or mysterious desktop folder.
Then we’ll put a process around it.