Credentialing

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Credentialing is an essential part of becoming a trusted healthcare provider. Credentialing is the precursor to contracting. It is important because most patients will only visit a physician within their insurance network. 

Providers want to expand their patient base by accepting new patients. Insurance companies can list you in their directory when a potential new patient is seeking out a new or specialized provider within their plan's network.

Using resources such as CAQH and PECOS, a provider can credential and contract with an insurance company. The process can be tedious and is time-consuming. The insurance company conducts a series of verification that includes background checks. They also verify a provider's education, competency, and legal authorization to practice.