Provider Credentialing in Florida: What Each Payer Publishes About Timing

If a Florida credentialing application is already in and you are asking whether the wait is normal, compare your filing date against the payer's own published standard. Each line links to the source; the full day-by-day script is further down.

• Medicare (First Coast), day 15 and day 50: 95% of clean online applications are processed within 15 calendar days and 100% within 50. Past day 50, the clock has almost certainly stopped for a reason the contractor can name.
• Florida Medicaid, day 21 and day 60: the deficiency window closes at 21 days; AHCA's processing standard is 60 days or less from a complete application.
• UnitedHealthcare and Simply Healthcare, day 45: UHC's join page says credentialing "generally takes up to 45 calendar days or more" from a completed application (its FAQ says up to 14, so day 14 is a fair first check-in); Simply says "typically" 45 days from a completed CAQH application. Past that, ask what the file is waiting on.
• Cigna, day 60: the top of its "typically 45 to 60 days."
• Florida Blue, day 90: the manual's own line — no communication within 90 days, call 1-800-727-2227.
• Any CAQH-based payer, day 120: re-attest CAQH whether or not anyone asked, or the profile expires and the file stalls.
• Aetna and Humana: no published overall figure to compare against. Request a written status at day 60 and keep CAQH current.

Not sure whether a payer's approval letter means you can bill yet? Credentialing, enrollment and contracting are three different steps; our page on what provider credentialing is puts them side by side.

This table shows what each payer has put in writing about credentialing timing, not what will happen to your application. All sources were read on September 26, 2026.

The spread is the finding. Medicare's 95% standard for a clean online file is about two weeks; UnitedHealthcare says 14 calendar days in one document and 45 or more in another; Florida Blue's "call us" threshold is a quarter of a year; Aetna declines to name a number. A single "Florida credentialing takes X days" figure cannot be true for all of them, which is why this page does not offer one.

First Coast Service Options, Florida's Medicare Administrative Contractor, publishes its CMS-855 processing standards, and they are the most specific figures any Florida payer offers. As of February 18, 2026:

• Online (PECOS), no site visit or fingerprinting: 95% of applications completed within 15 calendar days of receipt, 100% within 50.
• Online, with a site visit, development, or fingerprinting: 95% within 50 calendar days, 100% within 85.
• Paper, no site visit: 95% within 30 calendar days, 100% within 65.
• Paper, with a site visit: 95% within 65 calendar days, 100% within 100.

Two consequences are visible in the table itself. Filing on paper instead of through PECOS moves the 95% standard from 15 days to 30. Anything that triggers a site visit or fingerprinting moves it from 15 days to 50. The same page lists when the clock stops: an application referred to the Office of Inspector General or the Unified Program Integrity Contractor, or a provider referred to the Social Security Administration or the IRS to resolve a Social Security number or Tax ID discrepancy. A W-9 whose legal name does not match IRS records is not a typo at Medicare; it is a clock stoppage.

The rule with a dollar consequence is retroactive billing. Under 42 CFR 424.521, physicians and non-physician practitioners may bill for services furnished up to 30 days before their effective date if circumstances kept them from enrolling first (90 days after a Presidentially declared disaster). In a 50-day enrollment, only the last 30 days of visits fall inside that window.

Florida Medicaid's published processing standard is 60 days or less from the date a complete application is received, according to AHCA's provider readiness page. The same page carries the rule that decides whether an application gets there: deficiencies must be corrected within 21 days, and an application still deficient after that is denied. The only Medicaid application worth filing is a complete one.

Two Florida-specific steps sit outside that 60 days:

• Level 2 background screening. Florida requires a fingerprint-based Level 2 screen through the AHCA Background Screening Clearinghouse. The Clearinghouse FAQ says the full process "typically takes 7 to 10 business days"; the same FAQ says fingerprint transmission from the Livescan vendor to FDLE can take 24 to 72 hours and the criminal history review is generally completed within 5 to 7 business days after FDLE returns results. Book the Livescan appointment the week you decide to enroll, not the week the application is ready.
• Managed-care plan enrollment is separate. Fee-for-service enrollment with the state does not enroll a provider with Sunshine Health, Simply Healthcare, Molina, or any other Statewide Medicaid Managed Care plan. Each plan credentials and contracts on its own. Sunshine, for example, publishes no overall duration but commits to mailing written inquiries within 14 days and gives 21 days to dispute a discrepancy its verification turns up. A practice that finishes state enrollment and stops will find its managed-care claims simply do not pay.

Florida Medicaid provider enrollment is the application a practitioner or group files with the Agency for Health Care Administration (AHCA) through the Florida Medicaid Web Portal at portal.flmmis.com — usually called FLMMIS, run for AHCA by its fiscal agent, Gainwell Technologies — to receive a Florida Medicaid provider ID. Every Medicaid managed-care contract in Florida rests on that ID, so it comes first.

The portal's New Medicaid Providers page sets out the order. As read on October 23, 2026:

1. Read Chapter 2 of the Florida Medicaid Provider Enrollment Policy for the general requirements.
2. Choose the enrollment type (below). It decides who can pay you.
3. Choose the provider type and specialty. The portal's Provider Type and Specialty List shows which ones qualify for full, limited, or ordering/referring enrollment.
4. Run the Interactive Enrollment Checklist for that type, application and specialty. It lists the supporting documents you will be asked for.
5. Complete the Online Enrollment Wizard. An in-progress application can be saved, but the portal says all supporting documentation must be uploaded before the application can be submitted.
6. Write down the Application Tracking Number (ATN). You need it to start the background screen and to check status.

AHCA has announced a new provider enrollment system to replace the wizard; on October 23, 2026 the New Medicaid Providers page still sends applicants to the Online Enrollment Wizard. Check AHCA's Medicaid health care alerts before you file.

Full, Limited, or Ordering/Referring

The rule that governs all of this is Rule 59G-1.060, F.A.C., which incorporates the Florida Medicaid Provider Enrollment Policy (February 2026), effective April 8, 2026 (both read October 23, 2026). Section 2.7 says providers enroll as one of three types:

• Fully Enrolled: providers that "meet the full credentialing requirements for participation in Florida Medicaid" and can serve recipients in "either fee-for-service or managed care delivery systems." This is the type that bills the state directly.
• Limited Enrolled: the policy's definition is "Providers only participating in the network of a Florida Medicaid managed care plan." It is not a reduced scope of practice; it is a managed-care-only enrollment. Sunshine Health's credentialing page explains the background: AHCA created Limited Enrollment in December 2015 as a streamlined application, AHCA itself verifies licensure and reviews background screening and exclusion databases, and a Limited provider "cannot bill fee-for-service claims."
• Ordering or Referring is for a practitioner who only certifies a need for a service, prescribes, refers, sends a specimen to a lab, or acts as the attending practitioner. Section 2.10 adds that a practitioner whose only relationship with Florida Medicaid is referring, ordering, prescribing and attending "may enroll as a ROPA provider," and that "billing providers must obtain a full or limited enrollment."

A clinician who bills through a group is none of these on its own: the policy treats that as an application type, "sole proprietor enrolling as a member of a group," paired with full or limited enrollment and the group link described below.

Older plan material also mentions registered providers. Sunshine's page says registration "should be reserved for the use of health plans to obtain Medicaid IDs for non-participating providers," and that Limited providers do not need to register. A practice that will see Medicaid patients only through managed-care plans can use Limited Enrollment; a practice that will also bill the state directly needs Full Enrollment. The 60-day processing standard and 21-day deficiency window above apply either way.

Most stalled Medicaid files we see stall on data, not on the state: an address on the application that does not match the license or NPPES record, a document that lapsed while the file waited, or an NPI and tax ID that disagree across the application, CAQH and the state's records. That is why the intake list on what we need from you to start credentialing asks for every one of those up front. For the federal rules that apply in every state, see our Medicaid provider enrollment guide; Kentucky practices have the Kentucky version of this guide.

To check Florida Medicaid provider enrollment status, open the Enrollment Status page on the Florida Medicaid Web Portal and enter the Application Tracking Number (ATN) and the business or last name exactly as submitted on the application, including punctuation. The result shows the current status and a list of required supporting documents, marked as received by Medicaid or still needed.

The same page publishes what each status means and an average timeframe for it. These are the portal's own words and figures, read October 23, 2026; they are averages, not promises:

Three things on that page decide what to do next:

• "Application Deficient" starts the 21-day clock. Corrections go in through the portal's Correct Application feature, and the portal warns that not finishing it in a single session can make the Correct Application link disappear. Have every corrected document ready before you open it.
• "State Review" is not something the fiscal agent can explain. The page says Gainwell Technologies "cannot provide information regarding applications that are under review by the Agency." AHCA lists Provider Services at 1-800-289-7799 for enrollment questions.
• "Clearinghouse" for more than 14 days produces a deficiency letter. If the fingerprints were never taken, that letter is the first sign. The screening has to be started by you; see the next section.

To link an individual provider to a group in Florida Medicaid, the provider enrolls as a "sole proprietor enrolling as a member of a group" and the group submits the Group Membership Authorization, AHCA Form 5000-1061 (June 2019), available on portal.flmmis.com. Section 2.6.1 of the February 2026 enrollment policy says that authorization "is required when forming, joining, or separating from a group." Until the link exists, the group cannot bill fee-for-service for that clinician: the FLMMIS New Medicaid Providers page says fully enrolled groups "must ensure their individual group members are also enrolled" and "successfully linked to their Provider ID prior to submitting fee-for-service claims for payment."

Three records are involved, and each has its own owner:

• Joining: the clinician's own enrollment comes first, then the group's 5000-1061. A new hire with no Medicaid ID yet needs both, and the group cannot bill fee-for-service for that clinician in the gap.
• Leaving: section 5.6 says ending reassignment takes a written request with the effective date, the group's Medicaid ID and the provider's Medicaid ID, and either the provider or the group may send it. Ending the link does not end the clinician's own enrollment.
• Other changes: any change to the enrollment file must be reported in writing within 30 days (section 5); a change of ownership at least 60 days in advance (section 5.4).
• The plans: the state link does not touch the plans. Aetna Better Health says not to use its letter of intent to add an individual to a group that already participates; Molina and Sunshine add practitioners through their own portals and request pages. Ask each plan for the clinician's effective date under the group.

When claims for one clinician deny as not enrolled while the rest of the group pays, check in this order: is the clinician's own enrollment active (FLMMIS status, by ATN), was the 5000-1061 accepted for this group's Medicaid ID, and does the claim carry the clinician's NPI as rendering under the group? AHCA Provider Services (1-800-289-7799) can confirm the link. The step-by-step for every payer, not just Medicaid, is on adding a provider to your group; how to read status at each payer is on checking credentialing status.

Florida Medicaid requires a Level 2 background screening — a fingerprint-based state and national criminal history check run through AHCA's Care Provider Background Screening Clearinghouse — for the provider and, when the provider is a business, for each principal. Under Fla. Stat. 409.907(8) (2026 Statutes), principals include any officer, director, billing agent, managing employee, or affiliated person, and anyone owning 5 percent or more; the provider pays for the state and national record checks.

The order matters, and it is the step most practices get backwards. The FLMMIS Background Screening page says first-time applicants must submit the Medicaid application and receive their ATN before starting the background check in the Clearinghouse. So: submit, get the ATN, start the screen in the Clearinghouse the same day, then book the Livescan appointment. The Clearinghouse timing figures quoted earlier on this page start from there.

The same page explains why some providers get more than fingerprints. Under federal rules AHCA assigns every provider type a screening category of Limited, Moderate, or High, and depending on the category may verify licenses in other states, run database checks before and after enrollment, conduct an on-site visit, and require fingerprints. The plans check too: AHCA's January 2025 SMMC snapshot lists a Level II background check under Section 409.907 among the minimum criteria a plan confirms before credentialing a provider.

Site visits: what "pending site visit" means

Under section 4.3 of the February 2026 enrollment policy, AHCA may visit any provider, and it visits every provider in the moderate or high screening category before initial enrollment and at every renewal. The policy's lists put individual physicians, PAs, APRNs, chiropractors, dentists and practitioner-owned groups in the limited category; therapy groups (occupational, physical, respiratory, speech) and community behavioral health in moderate; and individually enrolling physical therapists and newly enrolling behavior analysis practitioners in high. On the status page a visit shows up as State Review, which the portal says runs under 60 days for an onsite visit.

The visit checks the service location, which must be fully operational when you apply: open during posted hours, ADA-compliant parking and access, a sign readable from twenty feet that identifies the services, and business hours and phone number posted on the front. The applying provider must be present. A moderate- or high-risk provider who lists a home address and works only in patients' homes, nursing homes or schools does not need a visit, per the same section.

Florida Medicaid providers must revalidate (the portal calls it "Provider Renewal") at least every five years: 42 CFR 455.414 says "The State Medicaid agency must revalidate the enrollment of all providers regardless of provider type at least every 5 years," and AHCA's provider readiness page lists a renewal cycle of every 5 years from the enrollment effective date. The February 2026 enrollment policy (section 6.1) splits it: non-institutional providers renew every five years; institutional, DME, Medicare crossover-only, ordering/referring and out-of-state providers every three. Sunshine Health's Limited Enrollment FAQ says Limited providers renew every three years, so read the expiration date on your own provider agreement rather than assuming any number.

Missing it is expensive. Section 6.2 says providers who do not renew before the renewal date "are ineligible for payment from Florida Medicaid under the fee-for-service delivery system and from a Medicaid managed care plan." A provider who already missed it should ask AHCA Provider Services (1-800-289-7799) whether the enrollment is still renewable or has to be filed new; the policy's reenrollment section allows a provider who terminated voluntarily to reapply.

Revalidation is not a form you sign; it re-runs the screening. AHCA's enrollment page says Level 2 background screening is part of revalidation as well as enrollment, under the same risk-based rules. And a lapse reaches past the state: AHCA's SMMC contract requires every plan to "continuously verify all providers have a current provider agreement with the Agency at regular intervals to ensure payments are not made to ineligible providers." An expired Medicaid enrollment stops managed-care payments too. Put the renewal date on the same calendar as CAQH re-attestation; our page on recredentialing and credentialing maintenance covers both cycles.

A Florida Medicaid ID makes a provider eligible; it does not put the provider in any plan's network. Each Statewide Medicaid Managed Care (SMMC) plan credentials and contracts on its own, and the plans require the Medicaid ID first. Molina's Florida page says you "must be an enrolled Medicaid provider and have a valid and active Medicaid ID issued by the Agency for Health Care Administration" to contract for SMMC; Sunshine's says "Assignment of a Medicaid ID does not guarantee a place in the network of any health plan." So the sequence is state enrollment, then each plan.

The plans are on a clock of their own, and it is the most useful sentence in Florida Medicaid credentialing. AHCA's SMMC Program Snapshot on provider credentialing (January 15, 2025) says:

• "SMMC plans shall fully enroll/on-board all providers they choose to contract with within sixty (60) days," and plans must report to AHCA the date they received a full and complete application.
• A plan that declines to add a provider must give written notice of the reason.
• Failing the contract's credentialing requirements, including background screening, "may result in liquidated damages of five thousand dollars ($5,000) per occurrence for the SMMC plan."

Note the words "they choose to contract with": the 60 days binds a plan once it has decided to take you, not a plan that is still deciding. When a plan file passes day 60, ask the plan for the date it recorded your application as complete. That is the date it reports to AHCA.

Plans differ by region. The 2025 contracts run in nine regions; in the Tampa Bay area, Region C is Pasco and Pinellas, Region D is Hardee, Highlands, Hillsborough, Manatee, and Polk, and Sarasota sits in Region F. The plans with network pages on AHCA's January 2025 list are Aetna, Community Care Plan, Florida Community Care, Humana, Molina, Simply, Sunshine, and UnitedHealthcare.

Florida Blue, UnitedHealthcare, Cigna, Aetna, and Humana read credentialing data from CAQH ProView rather than from a form you send them, and CAQH requires the profile to be re-attested every 120 days. A complete, attested CAQH profile is the precondition each payer needs to open a file; each one still runs its own verification, its own committee, its own effective date, and a separate contracting step that does not begin until credentialing clears. "CAQH is done" is not "credentialing is done."

• Florida Blue uses a vendor, Medversant, to verify credentials, and its manual says: "Be sure to comply with any response for additional credentialing information timely to ensure the application process is not delayed." A Medversant request that sits in a front-desk inbox for two weeks is two weeks added to the timeline. The manual's standards are a written decision within 30 business days of the committee and a 90-day threshold after which it invites you to call. Its February 2024 bulletin adds the CAQH consequence: a profile that is not current during recredentialing gets a "non-responder" designation, and "your agreement with us could be impacted."
• UnitedHealthcare's Join Our Network page (read October 23, 2026) says credentialing "generally takes up to 45 calendar days or more to complete" once it has a completed application and all required information, and that medical schools, residencies, specialty boards, and hospitals can affect the timeline. Its credentialing FAQ, dated October 14, 2026 and also read October 23, says "generally takes up to 14 calendar days." Both documents are current and they disagree, so plan on the longer one.
• Cigna publishes a typical duration, 45 to 60 days. "Typically" is an expectation, not a contractual maximum.
• Aetna publishes no day count. Its FAQ commits to sending a CAQH registration kit within 10 business days of the application request and states that its credentialing verification organization meets NCQA standards.
• Humana publishes no overall figure but does publish the freshness rules its committee works under: licensure, board certification, and malpractice verifications must be completed within 120 calendar days of the decision (a rule effective July 1, 2025) and everything else within 180 days. A file that stalls past 120 days is not just late; parts of it must be re-verified before it can be approved. Humana also commits to written notice of approval within 30 calendar days.

The "180 days" figure that appears on many vendor pages matches the verification window stated in Humana's policy and the NCQA standards UnitedHealthcare and Aetna say they follow. It is a rule about how old a verification may be at decision time, not a promise about how long an application takes.

Florida's main health plans each run their own credentialing, and they start in different places: Florida Blue through Availity, Simply and Aetna Better Health through CAQH, Molina through its own provider portal, UnitedHealthcare through Onboard Pro. This table summarizes each plan's own provider page as read on October 23, 2026; the blocks below give the detail and the link.

Florida Blue provider enrollment is two requests in Availity: first the Provider Registration Form, then the "Join our Networks" request, which, in the words of Florida Blue's Provider Manual, Section 01 (PDF generated September 24, 2026; read October 23, 2026), "initiates the credentialing process." In order:

1. Register. "To be considered for participation you must be a registered provider with Florida Blue," via the Provider Registration Form in Availity. Florida Blue's February 2023 network notice lists what that takes: Availity credentials (issued within 24 hours), a Florida Blue ID number, SSN and/or EIN, and an uploaded government ID, with every group practitioner registered too.
2. Check the network is open. The manual says "some of our provider networks may be closed or open only in limited areas" and sends you to its Network Status table first. For a closed network it says only that "you may check back with us periodically"; it describes no exception request.
3. Submit Join our Networks in Availity. Physicians apply through CAQH, which Florida Blue calls its "preferred method of application data," so the profile must be complete and attested. Facilities, ancillary providers, suppliers and ASCs do not use CAQH; Florida Blue sends them an application "only upon receipt of your request to participate."
4. Answer verification requests. Medversant verifies on Florida Blue's behalf and may ask for more. The manual's practitioner list includes a signed attestation within 180 days, the Florida license, five years of work history with any gap of six months or more explained, the malpractice face sheet, board certificate, privileges and DEA where they apply.
5. Committee decision. A written response "within thirty (30) business days" of the Credentialing Committee's decision. With all documents in and no communication within 90 days, call the Network Management Service Unit at 1-800-727-2227.

Four details catch Florida practices. The manual lists provider types "excluded from Florida Blue Participating Provider agreements ... unless explicitly included," among them LCSWs, LMFTs, LMHCs, behavior analysts, psychiatrists, psychologists and chiropractors, so those practices should confirm which network and agreement actually covers them before filing. APRNs, PAs and other advanced practitioners must get a Florida Blue provider number and register their NPI. Participation in one network "does not automatically mean that the provider participates in every network." And recredentialing runs every three years.

Florida Blue EFT enrollment is also in Availity: Florida Blue's EFT instructions (form 113450, March 2023) say to choose Enrollments Center, then Transaction Enrollment, and that registration "can be processed in as little as 48 hours but may remain open for a maximum of 30 days." The 835 ERA enrollment guide (form 113451) runs through the same Enrollment Center, needs the Transaction Enrollment or Administrator role, and requires the NPI to be registered with Florida Blue first. After approval, address or practice changes go in electronically through Availity at least 30 days before they take effect, which is also how the directory gets corrected; CAQH alone does not update Florida Blue's record.

Florida Blue is not on AHCA's January 2025 list of SMMC plans, so a Florida Blue contract does not reach Medicaid managed-care members. How the Blue plans work across states, and the national Florida Blue join and EFT detail, are on our Blue Cross Blue Shield credentialing page; to check where a Florida Blue file stands, see how to check credentialing status.

Simply Healthcare Plans credentials through CAQH ProView: its join-our-network page says to register with CAQH, authorize Simply to view your profile, and review and update the application, and that "the credentialing process typically takes 45 days from the time the credentialing department receives your completed CAQH application." Simply also asks for five years of work history in month/year format, may require a site review within 30 days of its request, and recredentials every three years. A practice not yet participating sends a letter of interest to Simply's Provider Relations office in Tampa; Availity is the plan's provider portal. Simply is an SMMC plan, so the Medicaid ID comes first.

Sunshine Health, a Centene plan, starts with its Network Participation Request Form and then credentials the provider from primary sources, including the National Practitioner Data Bank. Its credentialing page publishes no overall duration, but commits to answering written status inquiries by certified mail within 14 days and gives a provider 21 days to explain any difference between the application and what verification finds. Sunshine's site carries separate Medicaid, Health Insurance Marketplace, and Medicare Advantage sections; credentialing for one line is not a contract for the others, so name every line you want in the request. Its become-a-provider page (read October 23, 2026) names the lines as Medicaid, Marketplace (Ambetter Health) and Medicare (Wellcare), and splits the routes: non-contracted providers, or contracted ones adding a line of business, use the join request; contracted groups adding a practitioner use the Provider Enrollment Requests page instead. For Medicaid, the Florida Medicaid ID comes first; Sunshine's credentialing page adds that the ID "does not guarantee a place in the network."

Humana's Florida Medicaid plan, Humana Healthy Horizons in Florida, takes credentialing questions at Credentialinginquiries@humana.com and provider relations questions at FLMedicaidPR@humana.com, with Availity Essentials as its provider portal, according to its Florida SMMC provider quick guide. The same guide points providers back to AHCA's enrollment portal, and says CMS and state Medicaid contracts require every Humana-contracted provider to complete compliance program requirements each year. Humana's Florida Medicaid join page (read October 23, 2026) has four separate applications: medical, Long-Term Care, vision and behavioral health networks; pick the one that matches the services. Humana's commercial and Medicare networks are a different front door, "Join our medical network" on provider.humana.com, and run under the corporate policy described above, with its 120- and 180-day verification rules.

Aetna Better Health of Florida, Aetna's Medicaid plan, starts with a letter of intent: its join-our-network page says to complete the LOI (one form for facilities, one for groups) and email it, and warns not to use the LOI to add an individual to a group that already participates. It accepts credentialing applications through CAQH, and sends the fully executed participation agreement once credentialing is complete. Several specialties contract through vendors instead, including Behavioral Services Network for behavioral health, Doctor's Professional Services Consultants for chiropractic, and Health Network One/ATA for physical, occupational and speech therapy. Aetna's commercial network is a separate application (the join-the-network FAQ quoted above).

UnitedHealthcare Community Plan, UHC's Medicaid line, uses the same front door as its commercial network: a request in Onboard Pro inside the UnitedHealthcare Provider Portal, with a current DataSpring (CAQH) profile authorized for UnitedHealthcare where applicable. UHC's Join Our Network page says credentialing "generally takes up to 45 calendar days or more" (its credentialing FAQ, dated October 14, 2026, says up to 14; plan on the longer), that a contract may be mailed within 5 business days of a request but receiving it does not mean approval, that loading an approved, signed contract can take up to 60 days, and that some state Medicaid agencies also require a Disclosure of Ownership form. Its credentialing FAQ says Community Plan's state-specific rules are in the care provider manual and that the Onboard Pro dashboard shows each request's status in real time.

Molina Healthcare of Florida requires an active Florida Medicaid ID before it will contract, and its join-our-network page lays out four steps — connect, documentation, credentialing, contract — starting with a contract request in Molina's online provider portal. Contracted practices add practitioners or upload a roster in the same portal, and Molina asks for at least 30 days' notice of changes such as a new location or a change in tax ID or NPI. The page names no credentialing timeline and does not mention CAQH; we found no published Florida figure.

"Why is my credentialing taking so long" is usually asked from the middle of the process with no way to know whether the wait is normal. The payers' own thresholds are the calendar. Each check-in below is warranted by something the payer wrote down.

• Day 1 (any payer): confirm in writing that the application was received and is considered complete. Those are different facts, and the second is the one that starts every clock on this page.
• Day 15 (Medicare, online, no site visit): First Coast's 95% standard has passed. Check PECOS status; answer any development request the same day.
• Day 21 (Florida Medicaid): the deficiency window closes. If AHCA asked for anything, it must already be in. If you are not sure whether they asked, check the FLMMIS Enrollment Status page today.
• Day 45 (UnitedHealthcare, Simply): UHC's join-page "up to 45 calendar days or more" (well past its FAQ's 14) and Simply's typical 45 days have passed. Ask whether the file is in primary source verification, at committee, or waiting on a school or board; at UHC the Onboard Pro dashboard shows the request's status.
• Day 50 (Medicare, online): First Coast's 100% standard has passed for a clean application. A file still open now has hit a stoppage (OIG/UPIC referral, SSA or IRS discrepancy) or is waiting on the practice. Ask which.
• Day 60 (Florida Medicaid, Cigna, and any payer with no published figure): AHCA's ceiling and the top of Cigna's typical range. Request status in writing. For Aetna and Humana, which publish no overall figure, this is the first check-in with a defensible basis.
• Day 90 (Florida Blue): the manual's own threshold. Call the Network Management Service Unit at 1-800-727-2227 and select "Contract Inquiries." That is not escalating; it is doing what the manual says.
• Day 120 (anything CAQH-based): re-attest CAQH whether or not anyone asked. An expired profile stalls every CAQH payer at once, and Humana's 120-day verification rule means a file this old may need re-verification anyway. Every cycle that follows approval is on recredentialing and credentialing maintenance.

One question works at every point: "Is my file complete, is it in verification or at committee, and is anything waiting on me?" Payers do not volunteer the third part.

Every timeline on this page starts at "complete," so the one lever a practice controls is filing complete, once. This is the document set that satisfies every payer above. It is deliberately not gated behind a form.

• NPI confirmation — Type 1 for the provider, Type 2 for the group — with the taxonomy code matching the specialty you will bill
• Active, unrestricted Florida license; DEA registration if the provider prescribes controlled substances
• Malpractice declarations page showing current coverage that meets each payer's minimum
• CAQH ProView profile complete with no unexplained gaps in work history, attested within the last 120 days, with every target payer authorized to view it
• W-9 and EIN documentation that match IRS records exactly — at Medicare a name mismatch is a clock stoppage, not a correction
• Full malpractice and disciplinary history disclosed up front; payers verify through the National Practitioner Data Bank regardless, and a discrepancy triggers the manual review that takes longest
• Hospital privileges or an admitting arrangement where the specialty or payer requires one
• For Florida Medicaid: the Level 2 Livescan appointment booked, and the list of SMMC plans to apply to after state enrollment
• For Medicare: PECOS access, EFT banking information, and — for a reassigned or employed provider — the group's own enrollment confirmed before the individual application is filed
• One named person at the practice whose job is to answer payer requests the day they arrive

Running a practice while doing its billing teaches one thing about this list: the payer's clock is rarely the one that matters. The practice's clock is — the days a signed form sits, the weeks a Medversant email waits, the CAQH attestation nobody owns. That is the part a credentialing service is actually for: the file built and checked before submission, every payer's own threshold on a calendar, follow-up until each effective date is in writing. If you would rather hand it off, our provider credentialing services do exactly that at published flat pricing, including credentialing services in Clearwater, FL. If enrollment gaps are already showing up as unbillable visits, a free A/R audit will show where.

ClaimCarePro provides credentialing services and mental health billing services for independent practices and groups, with pricing published on each page.

For Florida Medicaid and the plans above, that means the FLMMIS application and the plan applications built from one checked file, the screening started the day the ATN arrives, and every payer followed up weekly with the rep's name, the date and the reference number logged. Flat pricing: $250 per payer application per provider, CAQH setup $250, re-credentialing $250, maintenance $99 per provider per year, or the new-practice bundle at $1,750 per provider ($1,400 each additional provider on the same group and payers). Start credentialing now and get a secure start link within one business hour, or call (844) 772-8902. Background reading: what provider credentialing is, CAQH explained, and the payer-by-payer credentialing hub.

Updated October 23, 2026. Sources without a date below were read on September 26, 2026; every source added on October 23 says so. If a payer changes its published standard, the linked page wins over this article. Regulatory summaries here are not legal advice.

• Florida AHCA, Provider Readiness: ahca.myflorida.com/provider/readiness.html ("60 Days or Less"; 21-day deficiency window)
• AHCA Background Screening Clearinghouse FAQ: info.flclearinghouse.com/faq.html (7 to 10 business days typical; 24 to 72 hours; 5 to 7 business days)
• First Coast Service Options, CMS-855 Enrollment Application Processing Timeframes (Feb 18, 2026): medicare.fcso.com
• 42 CFR 424.521, Request for payment by physicians and non-physician practitioners: law.cornell.edu/cfr/text/42/424.521 (30-day retrospective billing; 90-day disaster exception)
• UnitedHealthcare, Join Our Network — Medical Provider (read October 23, 2026): uhcprovider.com ("up to 45 calendar days or more"; Onboard Pro; contract mailed within 5 business days is not approval; up to 60 days to load; Disclosure of Ownership form for some Medicaid states)
• UnitedHealthcare, Credentialing and Recredentialing FAQ (PCA-1-26-01522, dated October 14, 2026, read October 23, 2026): uhcprovider.com ("up to 14 calendar days"; Community Plan credentialing in the state care provider manual; Onboard Pro status dashboard; NCQA standards)
• Florida Blue Provider Manual, Section 01: files.guidewell.com (30 business days; 90-day note; Medversant; complete-application requirement)
• Florida Blue CAQH Reminder bulletin, February 2024: files.guidewell.com (120-day re-attestation; non-responder)
• CAQH Provider Quick Reference Guide: caqh.org (re-attest every 120 days)
• Cigna, Credentialing: cigna.com/health-care-providers/credentialing (45 to 60 days typical)
• Aetna, Joining the Provider Network FAQs: aetna.com (registration kit within 10 business days; CVO meets NCQA standards; no day count)
• Humana, Credentialing and Recredentialing Policy (reviewed May 12, 2025): assets.humana.com (120/180-day verification windows; 30-day approval notice)
• Sunshine Health, Credentialing: sunshinehealth.com (14-day inquiries; 21-day dispute window)
• Florida Medicaid Web Portal (FLMMIS), Enrollment Status (read October 23, 2026): portal.flmmis.com (ATN lookup; status codes and average timeframes; Gainwell cannot discuss applications under Agency review)
• FLMMIS, New Medicaid Providers (read October 23, 2026): portal.flmmis.com (enrollment types; checklist; documents uploaded before submission)
• FLMMIS, Background Screening (read October 23, 2026): portal.flmmis.com (ATN before Clearinghouse; Limited/Moderate/High screening categories)
• AHCA, Provider Enrollment (read October 23, 2026): ahca.myflorida.com/provider/enroll.html (Full, Limited, ROPA; Level 2 screening at enrollment and revalidation; Provider Services 1-800-289-7799)
• Fla. Stat. 409.907(8), 2026 Florida Statutes (read October 23, 2026): leg.state.fl.us (Level 2 screening of providers and principals)
• 42 CFR 455.414, Revalidation of enrollment (read October 23, 2026): law.cornell.edu/cfr/text/42/455.414
• AHCA, SMMC Program Snapshot: Health Plan Processes for Provider Credentialing and Claims (January 15, 2025; read October 23, 2026): ahca.myflorida.com (60-day onboarding; $5,000 liquidated damages; regions; plan network pages)
• Simply Healthcare Plans, Join Our Network (read October 23, 2026): provider.simplyhealthcareplans.com (CAQH; 45 days typical; three-year recredentialing)
• Aetna Better Health of Florida, Join Our Network (read October 23, 2026): aetnabetterhealth.com (letter of intent; CAQH; specialty vendors)
• Humana Healthy Horizons in Florida, SMMC provider quick guide (630707FL1224; read October 23, 2026): assets.humana.com (credentialing and provider relations contacts; Availity Essentials)
• Molina Healthcare of Florida, Join Our Network (read October 23, 2026): molinahealthcare.com (Medicaid ID required; four steps; online portal)
• Florida Blue, network notice 113102 0223 (February 2023; read October 23, 2026): files.guidewell.com (Availity and Florida Blue registration both required)
• Rule 59G-1.060, F.A.C., Provider Enrollment Policy (effective April 8, 2026; read October 23, 2026): flrules.org
• AHCA, Florida Medicaid Provider Enrollment Policy, February 2026, incorporated by reference in Rule 59G-1.060 (read October 23, 2026): flrules.org (sections 1.2.10–1.2.20 definitions; 2.6.1 Group Membership Authorization, AHCA Form 5000-1061; 2.7 enrollment types; 2.10 ROPA; 2.13 21-day deficiencies; 4.2–4.3 risk categories and site visits; 5 30-day change reporting; 5.4 change of ownership; 5.6 reassignment; 6.1–6.2 renewal)
• Florida Blue Provider Manual, Section 01, re-read October 23, 2026 (PDF generated September 24, 2026): files.guidewell.com (Provider Registration Form and Join our Networks in Availity; closed networks; CAQH; excluded provider types; 30 business days; 90-day call; three-year recredentialing; 30-day data changes)
• Florida Blue, Electronic Funds Transfer Instructions and Definitions (113450 0323; read October 23, 2026): files.guidewell.com
• Florida Blue, Automated 835 ERA Enrollment (113451 0323; read October 23, 2026): files.guidewell.com
• Sunshine Health, Become a Provider (read October 23, 2026): sunshinehealth.com (join request; Provider Enrollment Requests; Medicaid, Ambetter Health, Wellcare)
• Humana Healthy Horizons in Florida, Join our network (read October 23, 2026): provider.humana.com (medical, Long-Term Care, vision and behavioral health applications)
• Sunshine Health, Credentialing (re-read October 23, 2026): sunshinehealth.com (Limited Enrollment explainer; registration; three-year Limited renewal)

Not found, and therefore not stated: a Florida statute setting a maximum credentialing turnaround for health plans (Fla. Stat. 456.047 and 641.315 were checked; neither contains one), and a published Florida-specific timeline from Molina.