Credentialed… Now What?

Why Ongoing Credentialing Support Is Critical for Your Practice’s Success

Getting credentialed with insurance payers is a major milestone—but it’s not the end of the road. Credentialing isn’t a “set it and forget it” task; it’s an ongoing process that requires regular maintenance to avoid coverage gaps, compliance issues, and revenue loss.

That’s why it pays to have a partner like CredEdge by ClinicMind on your side even after your initial credentialing is complete.

Staying Credentialed Means Staying Covered

Credentialing maintenance ensures you remain in-network with payers without interruptions. Missing a recredentialing deadline, failing to update required documents, or overlooking a contract expiration can result in lost revenue and major headaches.

CredEdge keeps you ahead of every deadline with transparent, proactive, and stress-free maintenance services—so you can focus on running your practice without worrying about administrative surprises.

The Hidden Risks of Neglecting Credentialing Maintenance

Once you’re credentialed, ongoing support becomes critical for a few reasons:

• Contract and Fee Schedule Changes: Payer contracts are living documents. Without regular checks, you might miss important changes that affect your reimbursement rates.
• Recredentialing Deadlines: Most payers require recredentialing every 2–3 years. Missing deadlines can cause you to be removed from networks temporarily—or permanently.
• Provider Updates: Adding new providers or making changes to your practice information must be handled properly to maintain compliance.
• Data Management: Insurance companies regularly update verification requirements (like CAQH profiles). Staying current ensures you avoid lapses in network status.

   

Without a team actively managing these moving parts, even established practices can face unnecessary disruptions.

Why Maintain Your CredEdge Account?

With CredEdge, you’re not just “credentialed”—you’re continuously protected and optimized:

•  Flat-Rate Pricing & Unlimited Payers: Add new payers anytime without renegotiating fees. Simple, predictable pricing based on your NPI and practice.
•  Dedicated Credentialing Experts: Meet with your credentialing team every two weeks on Zoom for updates, planning, and support.
•  Proactive Recertification Reminders: Never miss an important document or deadline. We track everything and remind you months in advance.
•  Payer Contract Health Checks: Regular reviews of contract dates, fee schedules, and payer behavior help prevent costly revenue issues.
•  Full Transparency: Access real-time updates, status tracking, and credentialing history through our easy-to-use portal.
•  Seamless Compliance and Verification: We update your CAQH profile every three months and ensure all verifications are continuously in place for in-network status.

More Than Just Credentialing—We Manage the Whole Process

Credentialing touches every part of your practice’s operations. That’s why CredEdge provides:

• Linking providers to the correct groups and facilities
• Workflow automation and database management
• Contract and facility management
• Verification and document management
• Committee reviews and e-documentation

   

Whether you’re a brand-new practice or a growing multi-provider group, having expert ongoing credentialing support is essential for scaling successfully.

Don’t risk unnecessary disruptions. Stay credentialed, stay compliant, and stay focused on patient care—with CredEdge by your side.

Learn more about CredEdge’s Ongoing Credentialing Support or call (234) 254-2255 to get started today!