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Front Office

New-Provider Credentialing Checklist

Step-by-step payer enrollment for a new NP, PA or physician: NPI, PECOS/CMS-855I, reassignment, CAQH, Medicaid and commercial plans.

Why I made thisCredentialing a new provider is months of forms, and one missed step means visits you can't bill. I wrote down the order I do it in.

$7

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Length
6 pages + 2 editable Word templates
Format
US Letter PDF (full color + low-ink print-friendly) and editable Word .docx (opens in Google Docs and LibreOffice). One .zip download.
License
Print and copy inside your own practice (one practice). Please don't resell or share the files.
This is also included in the Front Office & Billing Toolkit, with the other 7 guides in the set.

What's inside

  • Documents to collect the day the offer is signed
  • Medicare enrollment step by step: PECOS, CMS-855I, reassignment, effective-date and 30-day retroactive billing rules
  • What to report after enrollment, and when
  • CAQH (now DataSpring) upkeep
  • Medicaid and commercial plan enrollment
  • An editable credentialing tracker for every payer (Word)

Who it's for

  • Practice managers hiring a new provider
  • New NPs, PAs and physicians joining a small practice
  • Anyone who inherited credentialing with no handoff

Files you'll download

  • 05-New-Provider-Credentialing-Checklist.pdf (6 pages, color)
  • 05-New-Provider-Credentialing-Checklist-PrintFriendly.pdf
  • editable/Credentialing-Checklists.docx
  • editable/Credentialing-Tracker.docx
  • README.txt

Pairs well with

Instant downloadA .zip of PDFs and editable files, right after checkout.
Secure checkoutCard or PayPal through Payhip. I never see your card number.
Help by emailQuestions about a file? Email me.
No patient dataNothing here asks for PHI. Every example is made up.

Educational use only. Not legal, billing, coding or medical advice. Rules change and vary by MAC, state and payer, so confirm with the official sources (listed in the staff guides and Medicare kit). All examples are fictional. Not affiliated with or endorsed by CMS, HHS or any payer. Questions? Read the FAQ or email [email protected].