Starting a new medical office is exciting! But before you can treat patients and get paid by insurance companies, you need to go through an important process called credentialing and contracting. This makes sure doctors and other healthcare workers are approved to work with health insurance companies.

In this blog, we’ll explain what credentialing is, how to do it, how to sign up with insurance companies, and how a company like eServMD can help make it all easier.

What is Credentialing?

Credentialing is when insurance companies or hospitals check to make sure a doctor or healthcare worker is qualified to see patients. They look at things like education, training, licenses, and work experience.

If a provider isn’t credentialed, they can’t bill insurance companies or get paid. That’s why credentialing for new medical practices is so important.

Providers have to send in many documents, such as:

• A license to practice medicine

• A DEA number to prescribe medicine

• Proof of malpractice insurance

• A National Provider Identifier (NPI) number

• Their work history and references

If you're a mental health provider, it's especially important to go through insurance panel enrollment for mental health providers so your clients can use their insurance.

Some states and insurance companies have different rules, so there may be extra steps depending on where you live and what you do. This is called meeting the credentialing requirements for new clinics.

Also, credentialing is not something you do just once. Providers must keep their information up to date, renew documents regularly, and follow deadlines. Missing something can cause big problems, like losing the ability to get paid.

Steps to Get Credentialed

Here’s a simple step-by-step credentialing process for new healthcare providers:

1. Collect Documents: Gather licenses, certifications, and job history.

2. Make a CAQH Profile: CAQH is a website that helps providers share their info with many insurance companies.

3. Apply to Insurance Companies: Send in your applications to companies like Aetna or UnitedHealthcare.

4. Check In Often: It takes time, so you need to follow up.

5. Get Approved: Once approved, you can start seeing patients.

6. Update Every Few Years: Most insurance companies want new info every 2–3 years.

If you’re not sure how to get credentialed with insurance as a new provider, it's smart to work with experts like eServMD, who know exactly what each insurance company wants.

You can also use credentialing software or hire a team to remind you when documents need updates.

Signing Contracts with Insurance Companies

Once credentialing is in progress, the next step is contracting with insurance companies for new providers. This means signing agreements that let you be part of the insurance company’s network.

These contracts include:

• How much you’ll get paid

• Which services are covered

• How billing will work

• What happens if there’s a problem with a claim

Understanding the payer contracting process for new healthcare practices is important because once you sign, you must follow all the rules.

Some providers join insurance networks (in-network) to get more patients. Others stay out-of-network and charge more. eServMD can help you decide what’s best for your practice.

Each insurance company has its own rules and forms. You have to read them carefully, especially the parts about fees and ending the contract.

If you don’t know how to enroll in insurance networks as a new provider, don’t worry. eServMD can help with that too.

How Long Does It Take?

The credentialing timeline for new healthcare providers can be 2 to 4 months (60 to 120 days). It depends on:

• How complete your application is

• If there are delays with CAQH

• How busy the insurance company is

• How fast your references reply

For government insurance like Medicaid and Medicare credentialing for startups, it can take even longer.

Delays in credentialing mean you can’t get paid. That’s why New Practice Setup services from eServMD are so helpful. They make sure you’re ready to see patients as soon as possible.

Trying to rush the process or skipping steps often causes rejections. With eServMD, you don’t have to worry—they’ll help every step of the way.

How eServMD Helps New Practices

eServMD makes credentialing and contracting easier by:

• Helping you gather documents

• Updating your CAQH profile

• Sending applications to insurance companies

• Following up and keeping track of timelines

• Giving you updates so you know what’s happening

They also offer:

• Eligibility and Authorization: Checking if patients have coverage

• Medical Billing Services: Sending bills and getting paid

• Medical Coding: Making sure services are described the right way

• Revenue Cycle Management: Helping you understand your practice's money

• Practice Consulting: Making your office run better

• Accounting and Finance: Tracking income and expenses

They even help with:

• Hospital Billing

• Urgent Care Billing

eServMD offers insurance credentialing support for private practices and credentialing services for mental health clinics, depending on your needs.

Feeling stressed? Their team will even check contracts and help with billing systems so you can focus on patient care.

👉 Schedule a free demo and see how they can help.

Mistakes to Avoid

Here are some common mistakes when starting a new practice:

• Sending in old or missing documents

• Forgetting to renew credentialing info

• Signing contracts without reading the details

• Applying to only a few insurance companies

• Not matching your software setup with credentialing steps

Even small mistakes can delay your opening and cost money. That’s why it’s helpful to have a partner like eServMD.

Final Thought: Starting a new healthcare practice is a big step, but you don’t have to do it alone. With help from eServMD, you can make credentialing and contracting easier, avoid delays, and focus on helping patients.

👉 Schedule a Demo Today and get started now!