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START HERE: REQUIRED FOR ALL CARRIER MODULES
This is the core guide of the Credentialing Clarity Series.
Every carrier module (Aetna, Cigna, Optum, Moda, PacificSource, and Regence) builds on it and assumes you've already done these steps.
Moved offices? Changed your phone, fax, or group? If your carriers don't hear about it, claims get denied, checks go to the wrong address, and patients can't find you in the directory. This guide shows you what to update, where, and in what order.
Who it's for: providers, therapists, and practice staff who handle their own credentialing.
A credentialing service typically charges $50 to $150 for every change it submits to a carrier. This guide shows you how to make those changes yourself, as often as you need to.
What's inside
Why outdated information stalls claims and hides you from directories
What to have ready before you start
Step-by-step: USPS address check, NPPES, and CAQH ProView
How to notify your carriers and how long each update takes
How to confirm your updates went through
Common mistakes, and what to know about TIN changes
14-page PDF. Instant download.
How the series works
1. Get this master guide first. It has all of the basic information on how to get your update started.
2. Add the module for each carrier you're updating with.
3. Follow the steps in this guide first, then the steps in your carrier module.
START HERE: REQUIRED FOR ALL CARRIER MODULES
This is the core guide of the Credentialing Clarity Series.
Every carrier module (Aetna, Cigna, Optum, Moda, PacificSource, and Regence) builds on it and assumes you've already done these steps.
Moved offices? Changed your phone, fax, or group? If your carriers don't hear about it, claims get denied, checks go to the wrong address, and patients can't find you in the directory. This guide shows you what to update, where, and in what order.
Who it's for: providers, therapists, and practice staff who handle their own credentialing.
A credentialing service typically charges $50 to $150 for every change it submits to a carrier. This guide shows you how to make those changes yourself, as often as you need to.
What's inside
Why outdated information stalls claims and hides you from directories
What to have ready before you start
Step-by-step: USPS address check, NPPES, and CAQH ProView
How to notify your carriers and how long each update takes
How to confirm your updates went through
Common mistakes, and what to know about TIN changes
14-page PDF. Instant download.
How the series works
1. Get this master guide first. It has all of the basic information on how to get your update started.
2. Add the module for each carrier you're updating with.
3. Follow the steps in this guide first, then the steps in your carrier module.