Credentialing is not a one-time event. To remain in-network and continue receiving reimbursements, commercial payers and government programs require providers to undergo re-credentialing (or revalidation) typically every two to three years. Missing these critical deadlines can result in your practice being abruptly dropped from a payer's network, causing immediate revenue loss and patient disruption.
Proactive Re-Credentialing Services
At QUAD Healthcare Solutions, we eliminate the risk of lapsed contracts by managing your re-credentialing cycles proactively. Our services include:
- Cycle Tracking: We maintain a comprehensive database of your payer contracts and expiration dates, initiating the re-credentialing process well before payer deadlines.
- Medicare Revalidation: Expert handling of Medicare PECOS revalidations to ensure your billing privileges remain fully active without interruption.
- State Medicaid Renewals: Completing complex state-specific Medicaid re-enrollment applications including MCO renewals.
- Document Updates: Gathering and submitting updated primary source verifications, including renewed medical licenses, DEA certificates, board certifications, and malpractice insurance (COI).
- CAQH Sync: Ensuring your CAQH attestation is current before submitting re-credentialing applications so nothing is flagged.
Protect Your Revenue Stream
Payers rarely provide ample warning before terminating a contract due to expired credentials. When you partner with us, we act as your dedicated administrative safeguard. We respond to payer notices, submit updated applications, and follow up relentlessly until your re-credentialing is officially approved.
Typical Revalidation Timelines
- Medicare (Part B Physicians): Every 5 years via PECOS.
- Medicare (DMEPOS Suppliers): Every 3 years.
- State Medicaid: Every 3–5 years depending on the state.
- Commercial Payers: Every 2–3 years (varies by payer and specialty).