Insurance Panel Setup

Behavioral Health Credentialing & Payer Enrollment

CAQH/DataSpring, payer panel applications, recredentialing, and enrollment tracking for psychiatrists, PMHNPs, psychologists, and group practices, run as one workflow so nothing stalls.

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Your Payers And Providers

See Your Exact Credentialing Price.

Choose the work and counts. Rates are applied to each provider and payer path, and the full itemized total appears before checkout. Provider, payer, and state details move to secure post-payment onboarding.

What Are You Hiring Us to Do? * Providers * Commercial Payers *

Medicare And Medicaid Enrollments

Each Medicare, Medicaid, or Medicaid MCO program-and-state path is a separate enrollment. Choose the number of paths now; name the programs and states after payment.

Government Program-and-State Paths *

Review every line before continuing.

We work with all major commercial insurances, nationwide. UnitedHealthcare/Optum, Aetna, Cigna/Evernorth, Anthem/Elevance, your state’s Blue Cross Blue Shield plan, Humana, and regional plans, your choice of panels. CAQH build and alignment are included in every credentialing package, we maintain your profile data as an authorized practice manager; you complete and attest your own CAQH profile and sign any paper application a payer requires. Additional commercial payers are a flat $350 each, or $1,500 for a block of five; Medicare or Medicaid enrollment in any state is $500 per payer, available as an add-on to any commercial package. No AdvanceAPractice setup or software fee for the stated package scope. Approved add-ons above, third-party charges, and out-of-scope work are excluded unless listed.

Medicaid changes at the state line. Commercial carriers mostly follow your license, so one contract can reach every state you are licensed in. Medicaid does not, each state runs its own program, its own enrollment system, and its own rules about who you contract with after you enroll. See credentialing and payer enrollment by state for all 50 states and DC.

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What We Manage

Credentialing And Payer Enrollment, Managed From Start To Finish

From CAQH to approved panels, we run enrollment as one tracked workflow so nothing stalls waiting on a step no one owns.

CAQH Build & Maintenance

We build and maintain your CAQH DataSpring profile as an authorized practice manager and track every attestation due date. Attestation itself is yours: CAQH requires the provider to do it.

Payer Panel Applications

Commercial, Medicare, Medicaid, and managed behavioral health applications sent complete and followed through the queue.

Recredentialing

We track two-to-three-year cycles and expirable dates so panels don’t lapse between renewals.

Provider Readiness

License, DEA, malpractice, NPI, and group affiliation verified and current before a provider bills.

Status Visibility

Know The Status Of Every Payer Enrollment

Instead of chasing payers or living in a spreadsheet, you get one tracked view of every provider’s credentialing, which panels are approved, which are pending, and what happens next. Billing sees provider readiness before scheduling begins.

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AdvanceAPractice Command Suite credentialing hub tracking provider enrollment, CAQH status, and payer panel participation

How It Works

Three Steps To A Clear, Documented Payer Status

Prep CAQH

We build or update your CAQH profile data, gather documents, and confirm NPI, license, DEA, and malpractice are current before applications go out. You complete and attest the profile; we audit it first and tell you exactly what is missing.

Prepare And Submit Each Payer Path

Complete applications go to every relevant payer at once, not one at a time, so panels open on the shortest realistic timeline.

Document Each Status And Follow Up

We track each application through the payer queue, answer requests, and escalate stalls until an in-network effective date is confirmed.

FAQ

How The Work Moves

How Credentialing Actually Moves

Most credentialing delays aren't caused by the application. They're caused by the steps on either side of it.

Confirm What Kind Of Enrollment This Is

Joining an existing group contract, moving panels to a new Tax ID, and opening a first network are three different requests. Getting that wrong costs weeks before anyone notices.

Build The File Before Submitting

License, DEA where applicable, malpractice naming the correct entity, work history without gaps, and a current CAQH attestation. Payers reject on completeness long before they judge the provider.

Track Each Payer On Its Own Clock

Commercial plans, Medicare, Medicaid, and Medicaid managed care all run separate timelines and separate portals. We report status per payer, not as one average.

Get The Effective Date In Writing

Approved and effective aren't the same date. The effective date decides which claims get paid, so we ask for it in writing every time.

Credentialing FAQs

How Long Does Provider Credentialing Take?

Most payers take 60 to 120 days from a complete application, and some take longer. Because the clock effectively starts when the application is complete, gathering documents up front and following up regularly are the biggest levers on speed.

What Is CAQH And Do We Need It?

The CAQH DataSpring (formerly CAQH DataSpring) is the universal credentialing database most commercial payers pull from. Providers must keep the profile current and re-attest every 120 days, an un-attested or outdated profile is one of the most common causes of stalled credentialing.

Can A Provider Bill Before Credentialing Is Complete?

Generally no. Billing a payer before the provider has an effective in-network date typically results in denials. Some payers backdate to the application date, but many do not, so claims should be held until enrollment is confirmed.

Do You Handle Recredentialing And CAQH Maintenance?

We manage recredentialing (about every three years), keep your CAQH profile data current, and track license, DEA, malpractice, and attestation dates so nothing lapses and payments are not interrupted. One part is yours: attestation is the provider’s own act, so we alert you when your 120-day re-attestation is due and you attest it. We also do not complete or sign paper credentialing applications on your behalf where a payer requires the provider to sign them, we prepare those and tell you exactly what to sign.

For PMHNPs

Run A Psychiatric Nurse Practitioner Practice?

We keep a dedicated hub for PMHNPs, billing and coding, credentialing and payer enrollment, and scope of practice by state. Explore the PMHNP hub or PMHNP credentialing.

Before You Decide

What Practice Owners Ask Us First

Answered here so you do not have to email us to find out.

Do You Work With My Payers?

We support commercial enrollment work nationwide when the selected payer, product, practice type, and service location are eligible. Choose one to ten commercial payer paths, or choose government enrollment without a commercial package. We confirm each named path instead of assuming that one contract applies in every state or product.

Commercial payer paths: The first five use the rate for the selected service path. Payers six through nine are $350 each in the same engagement; selecting all of payers six through ten uses the $1,500 block.
Government Enrollment: $500 for each Medicare, Medicaid, or separately administered Medicaid managed-care enrollment path.

Whether a panel is open is the payer decision, not ours. If one you selected is closed, we tell you and redirect the work.

How Long Does This Actually Take?

The day you pay. Your engagement documents and secure onboarding open right away. Your start month is reserved.
Within three business days of your start month beginning and your intake being complete, work begins. We timestamp it and tell you.
First two weeks. Applications, rosters, portal registrations and EFT/ERA setup are built and submitted.
60 to 120 days per commercial payer. This is payer review time, and no vendor controls it. We chase every file on a documented cadence and you can see the status the whole way.
On approval. You get the written effective date, confirmed portals, and payment routing, so you know the day you can bill.

We provide dates for work we control and document payer-dependent milestones separately.

What Will You Need From Me?

Most practices already have all of this. You upload each item once, in your secure workspace, never by email.

Government photo ID
Current professional license for each state you practice in
DEA certificate and state controlled substance registration, for prescribers
Board certification and degree
Malpractice face sheet or certificate of insurance
IRS EIN letter, the CP 575 or 147C
Bank-issued ACH instructions or another payer-accepted proof of the business account
Your practice Type 2 NPI

For a launch or practice and Tax ID transition, we prepare the organization W-9 from the legal name and Tax ID and return it for signature as one task inside that engagement.

Providers must complete their own CAQH and DataSpring attestation. We prepare and align the supporting information, and we never ask for the provider's password.

Has This Worked For Practices Like Mine?

They clearly explained the confusing insurance billing process and helped me create a plan to expand my business.

John Benson, PMHNP-BCOwner, BBH Psychiatric Services

$10M+recovered in aged and unpaid receivables
16+ yearsin revenue cycle and credentialing

At one PMHNP practice practice, a contracted rate review found a payer discrepancy. Correcting it raised reimbursement 30% across four months of claims. Results vary by contract, payer, and claims.

Still deciding between two packages? Ask Practice Concierge or email hello@advanceapractice.com. We will tell you if a package does not fit before you spend anything.

We Stand Behind The Work

What Happens If We Do Not Deliver

Three commitments you are agreeing to at checkout, said plainly here instead of in the terms.

We Start On A Clock You Can See

In-scope work begins within three business days after your selected start month begins and we have complete onboarding and required access. We record Ready to begin and Work started timestamps and notify you when work starts, so the start date is a record rather than a promise.

We Fix Our Own Mistakes Free

If something we delivered does not work the way we said it would, we correct it at no charge for 30 days after delivery. You will not get an invoice for correcting our mistake.

If We Cannot Perform, You Get Your Money Back

We refund in full or in part where verifiable circumstances prevent the work: including serious illness, a licensure action that makes enrollment impossible, or our own inability to perform. We do not keep money for work we could not do.

What We Will Never Promise

We do not promise payer approval or payer timing because nobody controls those decisions. Commercial credentialing often takes 60 to 120 days, and a network can close while an application is pending.

Questions about any of this before you buy? hello@advanceapractice.com

Know Where Your Providers Stand.

Launching, hiring, or clearing a credentialing backlog, start with a clear look at what’s in place and what needs to move.