How long does the credentialing process take?

At some stage, every provider accepting insurance has expressed frustration with the credentialing process and the seemingly endless waiting time for insurance approvals. We understand your frustration. Now, let’s explore the different processing times.

• Medicare typically advises allowing up to 120 days for application approval. Nonetheless, Rush Credentialing consistently receives approval letters from Medicare by the 45-day mark. These approval letters also retroactively grant the provider an effective date 30 days before the application began processing. This enables the provider to deliver services to patients while the credentialing process is still in progress.

• Medicaid processing times fluctuate depending on the state. For example, Florida and Utah Medicaid process applications swiftly, sometimes within 40 days. Conversely, states such as New York, California, and Texas may take up to 120 days.

• For all other Commercial, Medicare, and Medicaid Advantage Plans, it is generally recommended to allow up to 120 days for application approval. These payers typically do not offer retroactive effective dates.

The time frames mentioned above generally apply to new providers and groups. However, if an already credentialed provider is transitioning from one practice to another, this can expedite the credentialing process with Commercial payers. Some may even issue approval in approximately 40 days.