By Ahmad Bashir · Updated October 26, 2026
Credentialing is how insurance companies verify a provider’s qualifications before adding them to their network. Until it is complete, claims for that provider may be denied or paid out of network, so it pays to start early.
Typical credentialing timelines
Every payer runs its own process, so there is no single answer. As a general guide:
- Medicare – often around 45 to 60 days for a complete application, longer if the contractor asks for more information
- Medicaid – varies widely by state, commonly 30 to 90 days or more
- Commercial payers – commonly 60 to 120 days, and sometimes longer for busy or closed networks
Overall, plan for about three to four months from start to finish, and longer if you are enrolling with many payers at once.
The credentialing process, step by step
1. Gather documents
State license, DEA registration if applicable, board certification, malpractice insurance, a CV with full work history and your NPI.
2. Set up or update CAQH ProView
Many commercial payers pull provider data from CAQH. The profile must be complete, with documents uploaded, and attested.
3. Submit applications
Medicare enrollment is done through PECOS, Medicaid through the state’s enrollment portal, and commercial payers through their own applications or CAQH.
4. Verification
The payer checks your license, education, training, work history and any sanctions with the original sources.
5. Contracting
For commercial plans, approval is followed by a contract that sets your rates and terms.
6. Confirm the effective date
Confirm the date you can bill as in network before scheduling patients under that plan.
What slows credentialing down
- Incomplete or inconsistent applications
- An expired CAQH attestation or missing documents
- Gaps in work history with no explanation
- Networks that are closed to new providers in your area or specialty
- No one following up with the payer
How to get credentialed faster
Start at least 90 to 120 days before a new provider’s first day. Keep CAQH current and re-attested, track every application, and follow up with payers regularly instead of waiting to hear back.
Want this handled for you? See provider credentialing services.