State Payers (Medicaid)
✔ Single Application per state
✔ State-Specific Rules (varies widely)
✔ Slower Processing (30-120 days)
✔ Mandatory Updates for license/address changes
Commercial Payers (Private Insurers)
✔ Payer-Specific Applications (each requires separate submission)
✔ Faster Approval (30-60 days typically)
✔ CAQH ProView Streamlines credentialing
✔ Contract Negotiation Possible for rates
Pro Tips
- Start Medicaid enrollment first (takes longest)
- Use CAQH for efficient commercial payer onboarding
- Track revalidation deadlines for both
