Guides and data for credentialing and billing agencies
Plain-language guides, checklists and state-by-state reference data, written for the people who keep providers enrolled. Sources are cited on every page.
Reference tables, with official sources
Checked against each state’s own publications. Free to use and download.
Business guides
How to start a credentialing business
Services, setup, contracts and BAAs, tools, pricing and your first clients.
Read the guideHow to start a medical billing and credentialing agency
Services, HIPAA and BAAs, clearinghouse and ERA enrollment, software, pricing and first clients.
Read the guideHow to scale a credentialing or billing company
What to standardize, measure and hand off as you grow into a team.
Read the guideHow to price credentialing services
Per application, per provider, maintenance and retainer models, and how to scope them.
Read the guideNew practice client onboarding checklist
Everything to collect and set up in a new client’s first week.
Open the checklistSpreadsheets vs credentialing software
When a spreadsheet is enough, where it breaks and how to migrate.
Read the guideGet the free Credentialing Checklist
The provider intake checklist from the Agency Playbook (Appendix A.1): every document and data point to collect before you start a provider’s payer applications. A printable two-page PDF, yours to adapt, sent to your inbox.
How credentialing works
What is primary source verification?
What gets verified, the sources, time limits and how to document it.
Read the guideNCQA credentialing standards
Accreditation vs Certification, time limits and the 36-month cycle, in plain language.
Read the guideCredentialing vs privileging vs enrollment
Who does each, what it produces and how they depend on each other.
Read the guideHow long does credentialing take?
What the timeline is made of, what causes delays and what you control.
Read the guideRecredentialing cycles explained
Payer recredentialing, Medicare and Medicaid revalidation and CAQH, side by side.
Read the guideOIG, SAM and state exclusion screening
Who to screen, which lists, how often, and what to do with a match.
Read the guideRun every client from one calm workspace
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