Your Credentialing Checklist
Credentialing can feel overwhelming, but preparing the right information from the start makes the process smoother.
This checklist outlines the essential documents and details you'll need to have on hand. Whether you choose to tackle this yourself or let us handle the heavy lifting, having these items organized is the first step toward building your in-network practice.
Essential Documents
✅Copy of Professional License: Your state-issued license to practice. Make sure it's current and in good standing.
✅Professional Liability Insurance (Malpractice) Certificate: A current copy of your liability insurance policy, including coverage amounts and policy dates.
✅W-9 Form: A completed and signed W-9 form for your business.
✅CAQH ProView Profile: If you don't have one, you'll need to create a profile with CAQH (Council for Affordable Quality Healthcare). This is a central, online database that most insurance companies use for provider information. Keeping it updated is critical.
✅NPI Number (Type 1 & Type 2): Your National Provider Identifier number(s). You will need both your individual NPI (Type 1) and your business/group NPI (Type 2).
✅EFT/ERA Enrollment Information: The bank account details for direct deposit (EFT) and how you wish to receive electronic remittance advice (ERA) for payments.
✅Business Entity Documentation:
LLC: Your Articles of Organization.
Corporation: Articles of Incorporation.
DBA: Your "Doing Business As" registration.
Key Information & Details
Beyond the documents, you'll need to gather specific details about your practice and your professional history.
✅Practice Information:
Legal Business Name and "Doing Business As" (DBA) name.
Physical practice address(es) and mailing address.
Business Tax ID (TIN/EIN).
✅Provider Information:
Full legal name, social security number, and date of birth.
Personal contact information (phone, email, home address).
✅Education & Training:
Degrees, certifications, and licenses with dates and institution names.
Internship, residency, and postdoctoral fellowship details.
✅Professional History:
A list of all work history and affiliations for the past 5-10 years, including employment dates and reasons for leaving. This must be accurate and without any gaps.
✅Attestation Questions:
Be prepared to answer a series of questions about your professional background, including any past sanctions, malpractice claims, felony convictions, or disciplinary actions from any state board.
The DIY Approach: You can gather all these items and submit them directly to each insurance panel's provider relations department. Be prepared for a lengthy process of forms, follow-up calls, and waiting.
The Valley Claim Solutions Way: You gather the items on this list once, and we do the rest. Our team takes on the extensive paperwork, tracks deadlines, and follows up with each insurance company so you can avoid the headache and focus on your practice.
Ready to get started? Let's schedule a brief consultation to discuss your practice goals and how we can get you paneled quickly and efficiently.