New Practice Credentialing Checklist: Before You Open
New Practice Credentialing: Start on Day 1
Every day of delayed credentialing is a day of delayed revenue. For a physician generating $30,000/month in insurance billings, starting credentialing 30 days late costs $30,000 in preventable revenue delay. Begin on the day your practice entity is formed. new practice credentialing services.
Pre-Launch Credentialing Checklist
- Business entity formed (PLLC/PC) with EIN from IRS
- NPI Type 1 (individual) registered at NPPES
- NPI Type 2 (group) registered at NPPES
- State professional license current
- DEA registration current (if prescribing)
- Malpractice insurance in force with new practice listed as insured
- CAQH ProView profile complete and attested
- CMS-855I submitted to correct MAC
- CMS-855B submitted for group entity
- CMS-855R submitted for billing reassignment
- State Medicaid application submitted
- All commercial payer applications submitted simultaneously
Related Resources
Free credentialing cost calculator | enrollment timeline calculator | Medicare checklist.
The Timeline Math Every New Practice Should Run
Credentialing takes 60–120 days. Your buildout, hiring, and marketing run on their own clocks. The expensive mistake is sequencing them: practices that wait until opening week to start credentialing spend their first quarter seeing cash-pay patients only. Start credentialing the day your entity exists — EIN issued, NPI registered — and your effective dates land near your open date instead of a quarter after it. For a physician projecting $30,000/month in insurance revenue, this sequencing decision is worth $60,000–$90,000.
Order of Operations
Week 1: entity formation, EIN, Type 2 NPI (group) and Type 1 NPI (individual) registration, malpractice policy bound with the new entity named. Weeks 1–2: CAQH profile built complete with the new practice address. Weeks 2–3: Medicare 855I + 855B + 855R filed together; state Medicaid application submitted; all commercial applications out simultaneously. Weeks 3–16: weekly follow-up on every application, deficiency responses within days, effective dates confirmed in writing. Parallel: credentialing-dependent decisions (EHR payer setup, fee schedule loading, scheduling templates) staged for activation. New practice credentialing service | cost calculator | full onboarding timeline.