Insurance Credentialing Services Checklist
for Mental Health Practices
Price Application
Per Provider
$150
1. Initial Information Gathering
• Collect personal information: full name, date of birth, Social Security number, and contact details.
• Obtain government-issued identification: driver’s license or passport. Gather proof of citizenship or legal residency: birth certificate, passport, or permanent resident card.
• Collect National Provider Identifier (NPI): both individual (Type 1) and organizational (Type 2) as applicable.
• Obtain Tax Identification Number (TIN) or Employer Identification Number (EIN).
• Gather malpractice insurance details: policy number, coverage limits, and provider information.
2. Work History and Experience
• Prepare a current Curriculum Vitae (CV) or resume.
• Obtain employment verification letters: from current and previous employers.
• Collect contact information for professional references: including supervisors and colleagues.
3. Educational and Professional Documentation
• Collect academic transcripts and diplomas: from undergraduate and graduate institutions.
• Obtain proof of supervised clinical training: including practicum and internship details.
• Gather state licensure information: including license number, issue date, and expiration date.
• Collect board certification details: including certification body and certification number.
• Obtain continuing education records: certificates of completed courses or workshops.
4. Credentialing Application Preparation
• Complete insurance provider-specific credentialing applications: including CAQH (Council for Affordable Quality Healthcare) profiles.
• Ensure accuracy and consistency across all submitted documents and applications.
• Submit required documents: as per each insurance provider’s specifications.
5. Submission and Follow-Up
• Submit completed applications and supporting documents to insurance providers.
• Confirm receipt of applications by insurance providers.
• Regularly follow up on the status of applications.
• Address any requests for additional information promptly.
6. Contracting and Enrollment
• Review and negotiate contract terms: including reimbursement rates and service coverage.
• Sign and return contracts to insurance providers.
• Ensure effective dates are confirmed and documented.
• Complete any additional enrollment forms required by insurance providers.
7. Ongoing Maintenance and Monitoring
• Monitor license renewals: ensuring all licenses remain active and in good standing.
• Track continuing education requirements: ensuring compliance with professional development standards.
• Update credentialing information: as necessary, to reflect changes in qualifications or employment.
• Respond promptly to any audits or re-credentialing requests from insurance providers.