How Long Must I Have My License Before I Can Be Credentialed? (Updated)

Provider Credentialing: How long must I have my license before I can be credentialed?

The majority of the insurance panels will allow you to apply right after you received your license. But there are a few that want a year, two years, or even three years. There are different regulations for each state. Some will require two years, and BCBS in GA, for example, only requires the two. Value Options will require three years, and UBH (United Behavioral Health) will require two years.

That being said, there are ways to get credentialed sooner. Usually you can get credentialed if you are past one year of holding your license. Since a lot of the credentialing process is regulated by the state, even with national insurance companies, the state has much to do with the process to apply.

In certain states, two years will be the minimum. But in most, and the majority of the country, UBH looks at someone who was licensed yesterday and applies today. AETNA does not have any regulations. They have taken people who have only held their licenses for a few months. The same goes with Cigna – no regulations. On the other hand, Humana requires that you be licensed for a year in certain states (NM for example). BCBS in GA wants at least two years. Other states vary. It is on a state-by-state level. In certain states, they require a certain number of hours. In North Carolina, they require at least 3,000 hours to be licensed.

Credentialing is a revolving process with no simple answer. If someone wants more information, they can call the insurance companies, or they can call us at 1-855-664-5154.

What is CAQH?

CAQH stands for Council for Affordable Quality Healthcare and it is a collation that insurance companies have formed together to develop one uniform application. Most people get confused thinking that they can just apply to the CAQH and then submit applications. But the CAQH is now a crutch used by the insurance companies. You have to submit your regular application as well as submit the CAQH application. What intended to make the credentialing process easier, is now a second level of applications that you have to jump through.

Had Enough of Fighting with Insurance Companies?

Have you had enough of fighting with insurance companies? Are you sick of filling out provider applications, just to find out your applications have been lost or stuck in a limbo? In other words, are you sick of concerning yourself with the credentialing process? Well, we have good news! You can step aside and hire us to do it for you. That’s right, we’ll take the wheel and get you on your desired insurance panels. Give us a call at 1-855-664-5154 to learn more about what this process looks like or to have any questions answered. You can also visit our FAQ Credentialing page to view some helpful videos.