How do I maintain my credentialing and recredentialing with insurance companies?
Maintaining your credentialing and completing the recredentialing process with insurance companies is crucial for ensuring uninterrupted billing and provider status. Failure to do so can result in being removed from a payer’s directory—or worse, being dropped from the insurance network altogether.
Stay on Top of Your Provider Portals
The specific portals you need to maintain will depend on the insurance companies you are credentialed with. Most providers will need to keep their information updated in key systems like CAQH, Availity, and American Specialty Health (ASH).
Re-Attestation: A Critical Step
Many provider portals require re-attestation every 120 days to verify that your credentials, practice locations, and other essential details are accurate. Below are key portals to maintain:
1. CAQH (Council for Affordable Quality Healthcare)
CAQH is the most widely used credentialing database, with approximately 75% of insurance companies relying on it for provider information. Keeping your CAQH profile updated ensures insurers can verify your credentials seamlessly.
When maintaining your CAQH profile, be sure to:
Verify your primary and alternative practice locations
Keep your malpractice insurance policy updated (policy number, effective dates, and insurer details)
Authorize commercial insurance companies to access your profile
2. Availity
Availity serves as a portal for multiple insurance providers, helping to maintain provider information.
To update your profile:
Log into your Availity account
Navigate to My Providers > Provider Data Management
Ensure service locations and demographic details are current
Complete the attestation process
3. American Specialty Health (ASH)
ASH is a third-party administrator responsible for provider enrollment for several insurance companies. If you're an ASH provider, make sure to:
Log into your ASHlink account
Check the upper left-hand side for a red “Provider Account Validation” message
Click the message to verify and update your information
Attest after confirming all details are accurate
Recredentialing: Keeping Your Status Active
Recredentialing is simple if you have consistently managed your provider portals. Typically, you or your credentialing representative will receive an email from the insurance company asking if you wish to remain in-network. They may also request updated copies of:
Your license
Your malpractice insurance
Other required documents
Proactive Management for Seamless Credentialing
To avoid lapses in credentialing, consider:
✔ Setting calendar reminders to track re-attestation deadlines
✔ Designating a team member or credentialing service to manage updates
✔ Promptly responding to requests from insurance companies
If you’re unsure about your credentialing status or need assistance navigating insurance portals, we’re here to help! Feel free to reach out with any questions.
