Provider Credentialing Checklist Generator
Instantly generate customized documentation, licensing, and electronic gateway requirements tailored to your provider classification. Avoid missing requirements and eliminate costly 60–120 day payer delays.
Standardized Credentialing & Compliance Audit
Submitting an incomplete or misaligned credentialing package is the single largest cause of prolonged enrollment lags often delaying practice reimbursements by 60 to 120 bussiness days.
Why Pre-Verification Matters
Whether establishing Medicare PTANs through PECOS, attesting your CAQH ProView profile, or contracting with major commercial payers like Aetna, BCBS, and UnitedHealthcare, every primary source document must be pre-verified and formatted to payer specifications before filing.
Primary Source Verification (PSV)
State & FederalUncompromised verification for state medical licenses, federal DEA certificates, and NPDB sanctions to meet NCQA & URAC standards.
CAQH ProView Profile Compliance
900+ Commercial PlansComplete 5-year work history reconciliation, eliminating gap inquiries and automating the 120-day re-attestation cycle.
Facility & DMEPOS Surety Audits
CMS ComplianceHome Health deemed status surveys, DMEPOS $50K surety bond verification, and professional liability coverage audits.
Electronic Clearinghouse Gateway
Direct PayoutsClearinghouse EDI 837 claim batch routing, automated ERA 835 remittance posting, and CMS-588 direct ACH deposit setup.
Select Your Provider Classification
Choose your organization or practice type below to immediately generate, verify, and export the exact credentialing and enrollment requirements mandated by Medicare, Medicaid, and commercial networks.
The 4 Foundations of Provider Credentialing
A complete credentialing dossier is not just paperwork it is the financial pipeline connecting your clinical encounters to uninterrupted reimbursement.
Primary Source Verification (PSV)
Direct, unalterable verification of medical school degrees, post-graduate residencies, active state medical boards, federal DEA certificates, and NPDB sanctions to meet NCQA & URAC standards.
- ✓State Medical Board Records
- ✓DEA Schedule 2-5 Verification
- ✓NPDB Sanctions & Malpractice Loss Runs
CAQH ProView Profile Compliance
Over 900 commercial and Medicaid health plans utilize CAQH ProView. We ensure full profile completion, eliminate work history discrepancies, and automate the 120-day re-attestation cycle.
- ✓100% Completeness Attestation
- ✓Quarterly Re-Attestation Guard
- ✓Seamless Payer Roster Authorizations
Government Payer PECOS & Medicaid
Specialized handling of CMS-855A, CMS-855B, CMS-855I, and CMS-855S submissions across regional MACs, ensuring flawless provider enrollment and re-assignment of benefits.
- ✓CMS-855 PECOS Gateway Submissions
- ✓Medicaid State Portal Filings
- ✓DMEPOS $50K Surety Bond Proof
Electronic Data & EFT Direct Payouts
Credentialing is incomplete without electronic billing gateways. We configure clearinghouse EDI 837 batches, link 835 electronic remittance advice, and execute direct deposit CMS-588 authorizations.
- ✓Clearinghouse EDI 837 Routing
- ✓Auto-Posting ERA 835 Remittances
- ✓EFT ACH Direct Bank Deposits
From Checklist to In-Network Payouts
How Code Credentia bridges the gap between document preparation and rapid payer enrollment approval.
Select Your Provider Archetype
Choose your classification Home Health Agency, Individual Provider, Medical Group Practice, or DMEPOS Supplier. The tool dynamically configures the corresponding federal, state, and commercial requirements.
Verify & Organize Documentation
Audit your clinical licenses, DEA certifications, malpractice coverage, CAQH ProView attestation, and facility occupancy documents against our comprehensive compliance standards.
Submit, Track & Activate Network Status
Print or export your dossier directly, or partner with Code Credentia’s dedicated credentialing specialists to handle PECOS, Medicaid, and commercial payer follow-ups until you are 100% active and billing.
Ready to Skip the Credentialing Paperwork?
Our credentialing team gathers documents, completes CAQH/PECOS attestations, and handles all payer follow-ups with 99% first-pass accuracy.
Maximize Revenue With AI Audit
Our medical billing and coding team will perform a comprehensive audit of your current RCM processes, identifying missed opportunities and potential areas for growth.
We are committed to helping you provide best-in-class care to your patients while we handle the complicated and time-consuming administrative tasks. Our specialized team handles everything from medical billing to healthcare marketing, ensuring your practice is optimized for maximum efficiency and growth.
Get a Complimentary Financial Audit for Your Practice
Meet our Customers
We care what our customers think of us and so should you.
We are partners in your business and your success is ours.
Reasons to Choose Code Credentia
As healthcare shifts to value-based care, Code Credentia provides adaptive solutions that ensure compliance, maximize reimbursements, and support your practice in this changing landscape.
Frequently Asked Questions
Everything you need to know about healthcare provider credentialing, documentation requirements, and payer enrollment workflows.
Credentialing turnaround varies by payer and provider type. Commercial health plans (Aetna, BCBS, Cigna, UHC) typically take 60 to 90 business days. Medicare Part B through PECOS averages 45 to 90 days. DMEPOS enrollment takes 90 to 150 business days, while Home Health Agencies involving state surveys and deemed status accreditations typically require 6 to 9 months. Starting your checklist early avoids costly delays.