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Feature · Recredentialing

Recredentialing and revalidation deadlines, never missed

Every approved enrollment starts a clock. Credentik keeps one for each provider, payer and state, works out the next due date from the rule that applies, and opens a prefilled application months ahead so the work starts before anyone has to remember it.

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One clock per enrollment

Every provider, payer and state has its own due date

A provider credentialed with four commercial plans, Medicare and two state Medicaid programs has seven separate cycles. Credentik creates a cycle for each approved enrollment, anchored to the latest approved effective date, and shows when the next recredentialing or revalidation is due and where that date came from.

Where the due date comes from

The first rule that matches wins, and the cycle shows which one it used:

  • A dated override on that cycle, with a reason
  • Your agency’s rule for the payer, in that state or payer-wide
  • Medicare: five years, or three for DMEPOS suppliers
  • The state’s published Medicaid revalidation cycle
  • Your agency default, or 36 months
State Medicaid schedules

Built on each state’s published cycle

Federal rules set a five-year minimum for Medicaid revalidation, but several states use three or four years and many shorten it for DME suppliers or high-risk providers. Credentik’s defaults come from each state’s own publications, with the source recorded for every state.

See the 51-state revalidation table and sources

Started early, on its own

Inside the lead-time window, Credentik opens one application for the cycle, copied from the previous one, with the recredentialing document checklist and any blocking requirements, and assigns it to the same owner.

  • Alerts at the lead times you choose (default 180 to 30 days)
  • Due-soon and overdue items in the work queue
  • Recredentialing section in team and client digests
Billing protection

Lapsed means not billable

When a cycle runs past its due date, claims for later dates of service are flagged. If the payer terminates on lapse, the claim gate treats the provider as not credentialed, so the problem shows up before the claim is sent, not when it is denied.

How credential-gated claims work

New to recredentialing? Read recredentialing cycles explained: payer, NCQA, Medicare and Medicaid timelines in one place.
Questions

Frequently asked

Which revalidation schedules are built in?
Medicare revalidation (five years; three years for DMEPOS suppliers) and a Medicaid schedule for every state and DC, taken from each state's official publications and last verified October 4, 2026. You can see the full table, with sources, on our Medicaid revalidation by state page. Your agency can override any of them.
Can we set our own cycle for a payer?
Yes. Add a rule for a payer, or for a payer in a specific state, and it takes priority over the platform default. You can also set a dated override on a single provider's cycle, with a reason, which is kept in the audit log.
When does Credentik start the next cycle?
By default it alerts at 180, 120, 90, 60 and 30 days before the due date. If the agency turns on automatic opening, it also opens one prefilled application inside that window, copied from the previous one and assigned to its owner. Each agency can change the lead times.
What happens if a recredentialing date passes?
The cycle shows as overdue in the work queue and an alert goes out. If your rules say the payer terminates on lapse, claims for dates of service after the due date are treated as not credentialed by the claim gate.

Keep reading

DataMedicaid provider revalidation by stateAll 50 states and DC: cycle length, provider-type exceptions and the official source for each.Read more GuideRecredentialing cycles explainedPayer recredentialing, Medicare and Medicaid revalidation and CAQH, side by side.Read more FeatureAutomatic reminders and chasers, instead of spreadsheetsA work queue, document chasers, digests and no-code automation rules.Read more

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