ClaimCarePro
Credentialing & Enrollment

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.

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 start

Every 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 start

Payers 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 start

This 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 start

Proves 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 start

Medicare 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 start

Service 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 (we send this to you)

Needed to start

Medicare and Medicaid require the owners and managing employees to be disclosed. We send you the form already filled in as far as we can; you complete the private details, sign, 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

Optional

Stops 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

Optional

This 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

Optional

Without 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 (we send this to you)

Needed to start

Legal name, home address, personal contact details and the identifiers payers require. We send it; you complete, sign and upload it.

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 start

No 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 start

Payers 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 start

Credentialing 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 start

Identity verification for Medicare and several commercial payers.

PDF, JPG, PNG or HEIC (a phone photo is fine)

DEA certificate and state controlled-substance registration

Optional

Only if the provider prescribes. If not, tell us and we mark it not applicable.

PDF preferred; a clear photo is fine

Board certification(s)

Optional

Several plans pay a higher rate or require it for panel participation.

PDF preferred; a clear photo is fine

Diploma, plus residency and fellowship certificates

Optional

Primary-source verification starts from these, and chasing a school later is slow.

PDF, JPG, PNG or HEIC (a phone photo is fine)

NBCE certificate (chiropractic providers)

Optional

Board scores are part of the chiropractic credentialing file.

PDF preferred; a clear photo is fine

Malpractice claims history (usually 10 years)

Optional

Committees 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

Optional

Fills 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

Optional

Some 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 (we send this)

Needed to start

Lets us talk to payers, CAQH and Medicare for you instead of putting you on hold.

PDF preferred; a clear photo is fine

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. 1

    We confirm within one business day

    You get a short list of anything still missing. No guessing, no silence.

  2. 2

    We prepare and submit every application

    And follow up with each payer every two weeks until there is an answer.

  3. 3

    We confirm each effective date in writing

    One point of contact, and a status list you can read at a glance.

  4. 4

    Typical timelines, honestly

    Most commercial payers take 90–180 days; Medicare is often 45–90. 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?
Send what you have and tell us what is missing. We chase the rest with you — a missing document changes the order we do things in, not whether we start.
Do I have to type my Social Security number anywhere?
No. Never on our website, never by text, never in an ordinary email. Private identifiers only ever travel inside a document you upload to your secure folder, and we will never ask you for them another way.
How long does credentialing actually take?
Most commercial payers take 90 to 180 days. Medicare is often 45 to 90. Anyone who promises you faster than that is guessing — what we control is that nothing sits waiting on us, and that you always know where each application stands.
What does it cost to start?
CAQH profile setup is $250 per provider, one-time. Payer and state application fees are passed through at cost as each application goes in — never marked up.
Can you work with a provider who has enrolled before?
Yes, and it is usually faster. Tell us which payers the provider is already in network with so we do not restart a clock that is already running.
Who actually does the work?
A named person, with 30+ years combined credentialing and billing experience behind them. You get one point of contact, not a queue.
Start now

Prefer to talk it through first? Contact us or call (727) 580-8186.