Re-credentialing is required every 2-3 years (varies by payer) to maintain network participation.
When to Re-Credential
✔ Medicare: Every 5 years (but update changes ASAP)
✔ Medicaid/Private Payers: Typically every 3 years
✔ CAQH ProView: Every 120 days (attestation required)
How to Do It
- Check Payer Deadlines (notifications often sent 90 days prior)
- Update CAQH/PPO Profiles (licenses, malpractice, work history)
- Submit Renewal Forms (Medicare: CMS-855R)
- Verify Approval Before Current Term Ends
