Credentialing Archives - Page 2 of 3

NPPES, CAQH, and PECOS sound interchangeable, they all hold provider data, and they all want the same information. But they're three separate systems with three distinct jobs, they don't sync automatically, and a mismatch between them causes denials. Here's what each does and how they interact.

Credentialing

June 16, 2026

By Mark Wood

The Cost of Credentialing Delays: What Every Day Actually Costs You

The credentialing process itself is cheap. The delays are what cost money, and they cost far more than most practices realize: $100,000 to $200,000 per provider annually through lost revenue, denied claims, and compliance risk. Here's the real financial picture, and why the math almost always favors getting credentialing done right and on time.

Credentialing

June 11, 2026

By Mark Wood

Type 1 vs Type 2 NPI: Which Do You Need?

The National Provider Identifier is not one thing. There are two types, Type 1 and Type 2, and most providers eventually need both. Getting them confused or trying to bill with the wrong one causes denials that are easy to avoid but expensive to fix.

Credentialing

June 08, 2026

By Mark Wood

Provider Credentialing: The Complete Guide

Provider credentialing is the gateway between hiring a clinician and that clinician generating revenue. It's also poorly understood and getting harder in 2026. This complete guide defines what credentialing actually is, walks through the full process, covers the systems involved, and links to detailed deep-dives on every subtopic.

Credentialing

June 05, 2026

By Mark Wood

Telehealth Credentialing: Multi-State Licensing Without Losing Your Mind

A provider must be licensed in the state where the patient is located, not where the provider sits. That one rule turns telehealth credentialing into a multi-state licensing problem. Here's how the compacts help, where they don't, and how to build a multi-state strategy that doesn't consume your whole team.

Credentialing

June 01, 2026

By Mark Wood

Medicare Enrollment Through PECOS 2.0: What Changed in 2026

CMS quietly launched PECOS 2.0 in late 2025 and the production system is now rolling out to every Medicare-enrolled provider through the end of 2026. The new system runs real-time validation against IRS, NPPES, and EFT data, flags inconsistencies as "Stay of Enrollment," and gives CMS expanded revocation authority. Here's what actually changed, what's already…

Credentialing

May 26, 2026

By Mark Wood

Group Practice Credentialing: Adding a Provider in 2026

Adding a new provider to a group practice is faster than fresh credentialing, but only if you know the structure. Two NPIs, two enrollment tracks, the CMS-855R, roster updates with each commercial payer, and an effective date that determines whether claims pay. Here's how it actually works in 2026.

Credentialing

May 20, 2026

By Mark Wood

Why Credentialing Applications Get Denied and How to Fix Yours

Most credentialing applications don't get denied because the provider is unqualified. They get denied because of eight or nine recurring mistakes in how information is submitted, verified, or matched across systems. Here's what each one looks like, why it happens, and how to fix it before the next submission.

Credentialing

May 18, 2026

By Mark Wood

CAQH ProView: The Profile That Quietly Controls Your Credentialing

Most new providers think the credentialing application is what payers verify. It isn't. For commercial payers, the source of truth is your CAQH ProView profile, and most credentialing delays start with something in that profile being wrong, incomplete, or out of date. Here's how it actually works.

Credentialing

May 08, 2026

By Mark Wood

Re-Credentialing: The Deadline Nobody Remembers Until It’s Too Late

Most practices don't lose revenue because credentialing failed. They lose it because re-credentialing got forgotten. Here's a plain look at the 36-month NCQA cycle, the 5-year Medicare revalidation, the 120-day CAQH attestation rule, and what actually happens when one of them slips past the deadline.

CAQH vs PECOS vs NPPES: What’s the Difference?

The Cost of Credentialing Delays: What Every Day Actually Costs You

Type 1 vs Type 2 NPI: Which Do You Need?

Provider Credentialing: The Complete Guide

Telehealth Credentialing: Multi-State Licensing Without Losing Your Mind

Medicare Enrollment Through PECOS 2.0: What Changed in 2026

Why Credentialing Applications Get Denied and How to Fix Yours

CAQH ProView: The Profile That Quietly Controls Your Credentialing

Re-Credentialing: The Deadline Nobody Remembers Until It’s Too Late

Introducing CredTrack: Real-Time Visibility Into Your Credentialing

Behavioral Health Credentialing in Tennessee: TennCare and Commercial

Days in AR: What’s Normal and How to Fix a Rising Number

Locum Tenens Credentialing: How It Works

Hospital Privileging vs Payer Credentialing: What’s the Difference?

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