Practice Implementation Center / CGM / Practice Administration / Credentialing

Credentialing

Overview

Credentialing is a process by which a health care provider is evaluated, verified, and approved by a payer or other organization to participate in its provider network and become eligible for contracting and reimbursement of covered services. Credentialing processes across different payers are the same as credentials data collection as defined by NCQA for all payers, but enrollment applications can vary and some may have more complex requirements than others. This resource will provide an overview of credentialing and help you understand how to successfully navigate the credentialing process with different payer types.

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