What We Need From You
Everything we need to enrol your practice and your providers with payers — in plain English, and in the order we use it.
Send what you have. Missing items do not stop us — we will tell you exactly what is still needed and chase the rest with you. Nothing here has to be perfect on day one.
Credentialing is mostly paperwork chasing, and the single biggest cause of a three-month delay is one document that arrived late or did not match another one. This page exists so that does not happen to you. It is the intake list behind our provider credentialing services, where the flat per-payer pricing and each payer's published timeline live. The three identifiers on the list each have their own explainer: CAQH, PECOS and NPI Type 1 vs Type 2. If you are opening a practice, the larger checklist is how to start a medical practice in Florida.
Check an NPI first: the free NPI and Medicare enrollment check shows what NPPES and the CMS public Medicare files list for it today.
We never ask you to type a Social Security number, date of birth or licence number into this page. Those live only inside the documents you upload, and we never ask for them by text message or ordinary email.
About the practice — once
One set for the whole organization, however many providers you have.
IRS letter showing your Tax ID (CP-575 or 147-C)
Needed to startEvery payer matches your practice to the IRS record. A mismatch of one character is the single most common reason an application is returned.
Lost the CP-575? Call the IRS Business line and ask for a 147-C letter — they fax it while you wait.
PDF preferred; a clear photo is fine
W-9 for the practice
Needed to startPayers will not set up payment to you without one.
PDF preferred; a clear photo is fine
Group NPI (Type 2) confirmation letter or NPPES screen
Needed to startThis is the number the group bills under. A screenshot of the NPPES page is fine.
Solo provider with no group NPI? Tell us — that is normal and we work from the individual NPI.
PDF, JPG, PNG or HEIC (a phone photo is fine)
State business registration / Secretary of State certificate
Needed to startProves the legal entity exists under the name on the application.
PDF preferred; a clear photo is fine
Voided check or bank letter for electronic payment
Needed to startMedicare and most commercial payers only pay electronically, and they will not take a typed account number without this.
PDF, JPG, PNG or HEIC (a phone photo is fine)
Your practice locations, on paper
Needed to startService address, mailing address, phone and fax for each place you see patients. A letterhead, a lease page or a typed list all work.
PDF, JPG, PNG or HEIC (a phone photo is fine)
Ownership disclosure form — signed (our form)
Needed to startMedicare and Medicaid require the owners and managing employees to be disclosed. Download our form once your agreement is signed, complete it, sign it, and upload it here.
This is the one document that carries private identifiers. Upload it here — never text or email it.
PDF preferred; a clear photo is fine
Existing payer contracts and effective dates, if you have any
OptionalStops us re-applying somewhere you are already in network, which restarts a clock for no reason.
PDF, JPG, PNG or HEIC (a phone photo is fine)
Which states and which payers you want, and any deadline
OptionalThis is the work order. A list in an email you print to PDF is perfect.
Not sure? Say so and we will propose a list from what your practice actually bills.
PDF, JPG, PNG or HEIC (a phone photo is fine)
CLIA certificate, if you run any in-office lab tests
OptionalWithout it, lab lines on your claims deny.
PDF preferred; a clear photo is fine
For each provider
One set per provider being enrolled. Adding a provider later is the same list again.
Provider information form — signed (our form)
Needed to startLegal name, home address, personal contact details and the identifiers payers require. Download our form once your agreement is signed, complete it, sign it, and upload it here.
Private identifiers belong on this form only — never typed into this page, never texted.
PDF preferred; a clear photo is fine
State licence(s) — every state you will practise in
Needed to startNo payer will enrol a provider who is not licensed in the state where the patient is seen.
Locums across several states? Send all of them — one per state.
PDF, JPG, PNG or HEIC (a phone photo is fine)
Malpractice certificate of insurance (current face sheet)
Needed to startPayers check the limits and the dates. An expired certificate stops an application cold.
PDF preferred; a clear photo is fine
Current CV, in month/year format
Needed to startCredentialing committees require month and year, and they ask about any gap longer than 30 days. Getting this right up front saves weeks of back-and-forth.
A Word CV is fine — print it to PDF, or just upload a photo of the pages.
PDF preferred; a clear photo is fine
Government photo ID
Needed to startIdentity verification for Medicare and several commercial payers.
PDF, JPG, PNG or HEIC (a phone photo is fine)
Social Security card
Needed to startMedicare verifies your SSN with Social Security and every application must carry the exact name on the card; one mismatch returns the application.
PDF, JPG, PNG or HEIC (a phone photo is fine)
DEA certificate and state controlled-substance registration
OptionalOnly if the provider prescribes. If not, tell us and we mark it not applicable.
PDF preferred; a clear photo is fine
Board certification(s)
OptionalSeveral plans pay a higher rate or require it for panel participation.
PDF preferred; a clear photo is fine
Diploma, plus residency and fellowship certificates
OptionalThe payer verifies education against these, and chasing a school later is slow.
PDF, JPG, PNG or HEIC (a phone photo is fine)
NBCE certificate (chiropractic providers)
OptionalBoard scores are part of the chiropractic credentialing file.
PDF preferred; a clear photo is fine
Malpractice claims history (usually 10 years)
OptionalCommittees ask for it. "None" in writing from the carrier counts.
PDF preferred; a clear photo is fine
Work history for the last 5 years and hospital privileges
OptionalFills the gaps a CV leaves, which is the question committees come back with most often.
PDF, JPG, PNG or HEIC (a phone photo is fine)
Background screening result, if one has already been run
OptionalSome state Medicaid programs require it; if you already have one we avoid paying for it twice.
PDF preferred; a clear photo is fine
Authorization for us to act on the provider’s behalf — signed (our form)
Needed to startLets us talk to payers, CAQH and Medicare for you instead of putting you on hold. Download it, have the provider sign it, and upload it here.
PDF preferred; a clear photo is fine
Why credentialing applications stall, and why each item on this list exists
In our casework, the most common cause is bad data from the providers, not slow payers.
Credentialing applications stall when the facts on them disagree: an old address, a lapsed license, DEA registration or malpractice certificate, or an NPI or tax ID that reads differently on the application, the CAQH profile and the state license board record. A payer compares those line by line, and every mismatch becomes a question, a wait and a clock that restarts from “complete.” Nothing on this list is paperwork for its own sake: each item is there so we can check one of those facts before a payer does.
| What stalls the file | The item on this list that prevents it | What we check before filing |
|---|---|---|
| An old or wrong practice address | Your practice locations, on paper; the group NPI confirmation | Each location matches NPPES, the CAQH profile and the W-9, suite number included, before any payer sees it. |
| Legal name or tax ID that differs between forms | IRS letter (CP-575 or 147-C), the W-9, the state business registration | The legal name and tax ID read the same, character for character, everywhere; a DBA goes only where a form asks for one. |
| NPI mix-ups | Group NPI confirmation; the signed provider information form | Individual and group NPIs sit on the right lines, and the NPPES taxonomy matches the specialty you will bill. |
| A lapsed or mismatched license | State licence(s), every state you will practise in | Active, unrestricted, with months left before expiry, and the name and address match the state board record. |
| A lapsed DEA registration | DEA certificate and state controlled-substance registration | Both current, and registered to the address the provider will practise from, not a previous office. |
| A lapsed malpractice certificate | Malpractice certificate of insurance; claims history | Coverage dates span the whole application window and the carrier matches what CAQH shows. |
| Work-history gaps or dates that disagree | CV in month/year format; work history and hospital privileges | CV dates agree with CAQH to the month, and every gap has a written explanation. |
| Restarting a payer you are already in | Existing payer contracts and effective dates | We update the existing record instead of filing a new application that starts the clock over. |
The same check repeats after you are in network. CAQH asks every provider to re-attest every 120 days (180 days for providers practicing in Illinois), according to its provider quick reference guide, so a renewed license or a new malpractice certificate has to reach the profile before the next payer reads it. The profile-specific errors are in the stall table on our CAQH explained page, and the order to fix them in, if you file yourself, is in our guide to getting credentialed with insurance companies.
Things we ask you about, not for
Accounts and logins are handled in conversation, through official third-party access. We never ask you to email or type a password.
CAQH ProView — the ID, or tell us there is none
If there is no profile we build one. That is what the $250 per provider covers.
NPPES (the NPI registry) access
Addresses and taxonomies have to match the application exactly.
PECOS / Medicare I&A access, if the provider has enrolled before
We connect through official third-party access — we never ask you for a password by email.
How to send it
You get a private link to your own secure folder. Nothing goes through ordinary email.
Once you start, you get a link to a page that belongs to your practice alone. You upload documents there — PDF, JPG, PNG or HEIC (a phone photo is fine) — and you can come back to it as often as you like. A photo taken on your phone is genuinely fine; we would rather have a readable phone photo today than a perfect scan next month.
Please do not text or email photos of documents that carry Social Security numbers or bank details. That is not a rule about you — it is true of everyone's email, and it is the reason the upload page exists.
What happens next
- 1
We confirm within one business day
You get a short list of anything still missing. No guessing, no silence.
- 2
We prepare and submit every application
And follow up with each payer weekly until there is an answer.
- 3
We confirm each effective date in writing
One point of contact, and a status list you can read at a glance.
- 4
Typical timelines, honestly
It depends on the payer, and only some publish a number: Florida Medicaid 60 days or less from a complete file, Medicare (First Coast) most clean online applications within 15 calendar days, UnitedHealthcare publishes two figures (its join page: generally up to 45 calendar days or more; its FAQ dated 10/14/2026: generally up to 14 calendar days), Cigna 45 to 60, Florida Blue 30 business days after committee. Every clock starts only when the file is complete. Payer and state application fees are passed through at cost, never marked up.
Questions people actually ask
What if I cannot find something on this list?
Do I have to type my Social Security number anywhere?
How long does credentialing actually take?
What does it cost to start?
Can you work with a provider who has enrolled before?
Who actually does the work?
Prefer to talk it through first? Contact us or call (844) 772-8902.