The Credentialing Timeline: How Long Does It Really Take to Get Approved?

Getting credentialed with insurance companies is a necessary step for therapists who want to accept insurance and expand their client base. However, the process is often time-consuming, complex, and varies by insurance provider. Many new private practice owners are left wondering: How long does credentialing actually take?

The answer depends on several factors, including the insurance panel, accuracy of your application, and how quickly you complete required steps. In this guide, we’ll break down the credentialing timeline, common delays, and tips for speeding up the process so you can start receiving insurance reimbursements as soon as possible.

Step-by-Step Credentialing Timeline

While the credentialing process varies, it typically takes 90 to 180 days from start to finish. Below is a breakdown of the major steps involved:

1. Gather Your Credentialing Documents (1–2 Weeks)

Before applying, you need to ensure you have the necessary information and documentation readily available. Missing or incorrect documents can cause delays, so preparation is key.

Required Documents Include:

National Provider Identifier (NPI) Number: Apply through NPPES.
Tax Identification Number (TIN) or Employer Identification Number (EIN): Recommended for professional and security reasons.
CAQH Profile: Most insurance companies use CAQH ProView to verify provider information. Complete your profile at proview.caqh.org.
State License & Malpractice Insurance: Ensure these are active and up-to-date.
Practice Information: Business address, contact details, and service locations.

Tip: If you don’t have a complete CAQH profile, many insurance companies will not process your credentialing request.

2. Submitting Your Applications (2–4 Weeks)

Once you have all necessary documentation, you can start submitting credentialing applications.

Private Insurance Panels: Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, etc.
Government Insurance Panels: Medicaid, Medicare
Employee Assistance Programs (EAPs): Optum, Magellan, etc.

Each insurance provider has its own application process and requirements, but most require you to submit your CAQH profile, provider details, and proof of licensure.

Tip: Some panels are closed, meaning they are not currently accepting new providers. However, you can often submit a request to be reconsidered in the future.

3. Application Review & Primary Source Verification (60–120 Days)

After submission, the insurance company begins the verification process, which involves:

Validating your credentials (license, degree, and certifications).
Checking for malpractice claims or disciplinary actions.
Verifying employment history and references.

This stage is often the longest part of credentialing and can take anywhere from two to four months depending on:

The insurance company’s processing time.
The completeness of your application.
Whether additional verification is required.

Tip: Regularly check in with the insurance company to ensure there are no missing documents.

4. Contracting & Provider Enrollment (30–60 Days)

Once credentialing is approved, you must sign a contract with the insurance company outlining:

Your reimbursement rates.
Policies for submitting claims.
In-network provider requirements.

After the contract is signed, you are officially enrolled in the insurance network and can begin submitting claims.

Common Delays in the Credentialing Process

Even though most providers expect credentialing to take 3–6 months, certain factors can slow down the process even further:

🚩 Incomplete or Incorrect Documentation: Missing or incorrect information is the #1 reason for credentialing delays.

🚩 Delays in CAQH Attestation: Many providers forget to update and attest their CAQH profile, causing insurance companies to pause the process.

🚩 Slow Insurance Processing Times: Some insurance panels simply take longer to process applications.

🚩 Credentialing Backlogs: If an insurance company has a high volume of new applications, processing may take longer than usual.

🚩 Closed Insurance Panels: If a panel is not accepting new providers, your application may be delayed or denied.

How to Speed Up the Credentialing Process

Although the process can be lengthy, there are several strategies to reduce delays and get credentialed faster:

✔ Start Early: Begin gathering documents before you leave your current job or start your private practice.

✔ Double-Check Your Application: Ensure all information is accurate before submitting.

✔ Complete & Attest Your CAQH Profile: Many insurance panels will not process your application until CAQH is up to date.

✔ Follow Up Regularly: Check the status of your application every 2–3 weeks to avoid unnecessary delays.

✔ Work with a Credentialing Professional: Hiring an expert can help you avoid errors, track deadlines, and expedite the process.

Frequently Asked Questions

Q: Can I start seeing clients while waiting for credentialing approval?

A: If your insurance contracts allow for retroactive billing, you may be able to bill for sessions once you’re approved. However, not all insurance companies allow this, so check with each payor directly.

Q: What happens if my application is denied?

A: If your application is denied due to errors or missing documentation, you can typically resubmit with corrections. If it’s denied because the panel is closed, you may need to reapply later or appeal the decision.

Q: How do I know which insurance panels are worth joining?

A: Research each insurance company’s reimbursement rates, claim processing times, and provider support. If reimbursement is too low, you may want to reconsider joining.

Credentialing is a time-intensive but necessary process for therapists who want to accept insurance. By preparing your documentation in advance, keeping your CAQH profile updated, and following up consistently, you can reduce delays and get credentialed as quickly as possible.

If you’re struggling with navigating the credentialing process, handling insurance paperwork, or dealing with delays, we can help. Our team specializes in credentialing therapists efficiently, so you can focus on what matters—your clients.

SCHEDULE A CONSULTATION

Download Your Free Credentialing Checklist for New Therapists

Navigating the credentialing process can be overwhelming, but having the right information upfront can make all the difference. Our free step-by-step Credentialing Checklist will help you:

✔ Identify the key documents and accounts needed to start credentialing

✔ Avoid common mistakes that cause delays

✔ Stay organized and streamline your application process

DOWNLOAD NOW