Our Credentialing Process: What To Expect

Disclaimer: The timelines below are approximate, not guaranteed. To prevent delays, you must reply promptly to our requests and submit all documents in a timely manner.

 

Things you’ll need before you begin:

  • Practice location that you don’t plan to change anytime soon. Changing during the credentialing process is not possible and we’ll have to charge an extra fee to do it after that, so be sure of your location!
  • Tax ID number. If you don’t have one, visit the IRS website to apply. If you want to use your SSN, that’s possible, but not recommended. Talk to your accountant.
  • State License. An active state-issued medical license for your specialty is required.
  • Malpractice insurance with minimum limits of $1 million/$3 million.
  • NPI number. You can get one here.

Step 1: We gather your information

  • We collect your practice demographics, license, malpractice insurance policy, and other supporting documents.
  • We generate your CAQH account. Already have one? We’ll vet it for red flags that may slow down or invalidate your credentialing.
  • We move quickly. You’ll need to move quickly too!

Timeline: 1 week

Step 2: We help you pick your carriers

Which companies should you apply for? We help you determine the best choices for your practice.

  • Eligibility. Which companies are you eligible to apply for?
  • Goals. Are you interested in seeing more patients, or refining your practice to increase your profits?
  • Opportunities. Your patients may be insured through regional carriers. Should you apply with those carriers?

Timeline: 1-2 days.

Step 3: We submit your applications & follow up

  • After submitting your application, we call the carrier to confirm receipt.
  • 60-120 business days: we call regularly for status updates and respond to requests for further information.
  • Once you’re in network, we confirm the effective date. If necessary, we fix any mistakes the carrier made when recording your information.
  • Be attentive to phone calls and letters from the carrier. If they contact you for any reason, tell us right away. We’re counting on you!

Timeline: 3-6 months (but sometimes longer).

PLEASE NOTE: At Alchemy Credentialing, we work hard to credential you quickly and accurately. Unfortunately, credentialing and data management for Aetna has become so challenging that it thwarts our efficiency measures. We’ve found that the time we spend on Aetna does not adequately resolve the issues we’ve had with them.

As such, we’ve discontinued our credentialing efforts with Aetna to focus our energies where they will have the greatest impact. For providers who would like to credential with Aetna on their own, we are happy to provide basic information. Just ask us!