Credentialing is a process where insurance companies like Aetna check your background to make sure you’re qualified to provide healthcare services. It’s like Aetna’s way of ensuring you have the right education, licenses, and experience to safely care for their members. Aetna requires credentialing before they accepts claims from providers. This step helps protect patients...
The Provider Enrollment, Chain, and Ownership System (PECOS) is Medicare’s official online platform designed to help healthcare providers, groups, and suppliers manage their Medicare enrollment smoothly. Instead of dealing with complicated paper forms, PECOS offers a digital way to apply, update, and maintain your Medicare enrollment information all in one place. Managed by the Centers...
Recredentialing is one of the most important — but often overlooked — parts of staying active with insurance networks. Even if a provider has been credentialed before, payers require regular rechecks to ensure they still meet all quality, licensure, and compliance standards. Whether you’re a solo provider, part of a group practice, or manage a...
Credentialing has always been one of the biggest roadblocks for healthcare organizations. Whether you run a growing mental health group, a primary care clinic, a specialty practice, or an MSO, you already know the problem — every new provider means more paperwork, more follow-ups with payers, and long waiting periods before they can start seeing...
CAQH ProView is an online system where healthcare providers keep all their professional information in one place. Think of it as your digital credentialing profile that insurance companies rely on. Instead of sending your licenses, education details, and work history to every payer separately, you upload everything once into CAQH ProView—and payers pull the information...
If you’re a mental health provider, whether you’re a therapist, counselor, psychologist, or social worker, credentialing is one of those tasks you can’t avoid. Insurance companies want to verify your education, license, training, and background before they let you join their network. And without being in-network, it’s harder to get steady patients, and even harder...
Getting credentialed with an insurance company like Cigna is one of the most important steps for any healthcare provider looking to grow their practice. It’s what allows you to join Cigna’s provider network, see patients covered by their plans, and get paid for your services without billing headaches. In simple terms, credentialing is the process...
If you’re a Nurse Practitioner (NP) or about to become one, you’ve probably heard the word credentialing more than once. But what exactly does it mean — and why should you care? In the simplest terms, credentialing is the process that confirms you’re licensed, certified, and qualified to provide care and bill payers (like Medicare,...
Credentialing is the process that proves you’re licensed, qualified, and ready to work as a therapist or mental health professional. It isn’t just a paperwork hurdle—credentialing is what lets you join insurance networks, earn reimbursement for your services, and build trust with both clients and payers. Without it, you risk missing out on clients who rely...
If you’re a new provider ready to launch your practice, there’s one key hurdle you can’t skip: getting credentialed. Credentialing is what lets you join insurer networks, bill for services, and actually start seeing patients—they don’t just hand you that approval overnight. When it takes too long, your billing is stalled, and your revenue drops....