Frequently Asked Questions

General Information

  • You can reach us anytime via phone, email or our contact form We will respond quickly—usually within one business day.

    Established clients will have a direct email address for their dedicated Credentialing Specialist for quick questions and check-ins.

  • Our services are available for healthcare providers working in the United States (all 50 states). We do not currently provide services to healthcare providers working in the US Territories, but plan to expand soon!

  • We accept the following payment types through our website and also by invoice. Our payments are processed securely by Squarespace Payments or PayPal.

    • Credit & Debit Cards: Visa, Mastercard, American Express, Discover, Diners Club, JCB, and UnionPay.

    • Digital Wallets: Apple Pay, Google Pay and Link (by Stripe)

    • ACH Bank Transfer

    • PayPal

  • Credentials 360 combines U.S.-based credentialing expertise, transparent flat-fee pricing, compliance-focused services, personalized support, and an Accuracy Guarantee. We are committed to following industry best practices while providing healthcare professionals with a knowledgeable credentialing ally they can trust.


  • Requirements vary by service but typically include:

    Copies of professional licenses, complete education and training history (starting at the university/undergrad level), complete work history for last 10 years, malpractice insurance information, board certifications, identification documents, and practice information.

    Your Credentialing Specialist will provide you with a list of the documentation and information that will be needed for your service.


  • No. Credentials 360 generally does not require patient records or Protected Health Information (PHI) to perform credentialing, enrollment, verification, licensing, or compliance services. Please do not submit patient records.


  • No. Credentialing, enrollment, licensing, and participation decisions are made by payers, Medicare, licensing boards, healthcare facilities, and other third parties. Credentials 360 cannot guarantee approval, participation status, reimbursement rates, or processing timelines.


  • No. Credentials 360 will never ask for your passwords, authentication codes, security questions, or other account credentials. We follow industry best practices and believe providers should maintain control of their own account security and required attestations.


  • We pride ourselves on precision. If an insurance network requests corrections or rejects an application due to a clerical error on our part, we will manage the necessary corrections and administrative updates at no additional cost to you.

  • Provider credentialing is the vetting process used to verify a clinician's qualifications, including education, training, licenses, certifications, and work history. There is also Organizational Credentialing or Facility Credentialing for verifying a healthcare location’s qualifications.

    Frequently, other related processes such as payer enrollment or applying for privileges are also called “credentialing”, though they are actually different processes that include credentialing/PSV as a foundational requirement. Applying for a new professional license also requires credentialing/PSV.

    Provider credentialing goes beyond a standard background check and systematically verifies that a provider is who they say they are. It requires the Primary Source Verification (PSV) of the provider’s credentials.

    Hospitals, healthcare organizations, insurance companies, government agencies, healthcare staffing groups, and licensing boards conduct this deep background check using primary source verification. This PSV of the provider’s credentials  is mandated through laws, regulations and policies to protect patient safety and ensure that the provider is legally and medically qualified to practice. This provider credentialing step is required for the granting of privileges, issuing of a license, enrollment in an insurance panel or hiring.


  • Credentialing timelines vary depending on the type of service, the payer (for enrollments), the organization (for licensing and applications), and individual circumstances. 

    The services that we perform in-house are typically completed within a few days to a few weeks. They include: Primary Source Verification/Expedited PSV, Credentials Readiness Audit, and our 360 Compliance Subscription

    Most payer enrollment processes as well as licensing take several weeks to several months.

    While Credentials 360 helps ensure applications are complete and accurate to prevent additional delays, processing timelines for services that involve payers, licensing boards or primary sources are determined by third parties and are outside of our control.

    Your Credentialing Specialist will provide you with an estimated time for completion for the specific services you choose.


Answers About Our Services

  • Though all three are often called “credentialing” in the industry, they are actually different processes. What they do have in common is that all three process require primary source verification (PSV) of credentials.

    • Credentialing is primary source verification (PSV) of the provider’s professional background, education, and licenses.

    • Privileging is a specific medical facility granting permission for the provider to perform specific procedures based on their verified skills.

    • Enrollment (Payer Enrollment) is registering the provider with insurance networks (like Medicare, Medicaid, or private insurers) so the practice can legally bill and receive reimbursement for their services.

  • Welcome! We specialize in setting up your foundational credentials, including NPI registration, initial licensing support, and CAQH/DataSpring setup. We take the credentialing management and administration off your plate so you can focus on your patients.

    Schedule your free consultation with us to discuss your goals as we create your roadmap.

  • DataSpring (formerly CAQH: Council for Affordable Quality Healthcare) hosts the largest repository of centralized healthcare practitioner credentialing information in the United States.

    More than 900 healthcare organizations, facilities and health plans, and 90% of commercial health insurance companies, use DataSpring Profiles for practitioner credentialing, enrollment, compliance monitoring and directory information.

    Previously a not-for-profit organization, CAQH was restructured and rebranded as DataSpring in 2026, a for-profit corporation owned by a consortium of 12 major health insurers

    DataSpring has communicated that for now CAQH Provider Profiles will remain active and unchanged.

  • Yes. Our Credentialing Readiness Clean-up & Audit Service ensures your files are fully compliant for licensing, employment, and payer audits. We fix gaps before they cause revenue delays or enrollment rejections.

  • Primary Source Verification (PSV) is the verification of a healthcare provider’s credentials (licenses, certifications, education and training) directly with the original issuing institutions (medical schools, state licensing boards).

    Traditionally, Credentialing Specialists performed PSV manually. Currently, PSV is performed either entirely manually or using a hybrid method that utilizes both automated verifications (commonly for state issued licenses) and manual processes performed by Credentialing Specialists.

    The acceptable sources for primary verification, and the credentials to be verified, are mandated by different accrediting bodies including: NCQA‍ ‍URAC and TJC

    While NCQA, URAC, and TJC all mandate Primary Source Verification (PSV) to ensure patient safety and compliance, they apply these standards differently based on the type of healthcare organization they govern. TJC focuses on hospital privileging, NCQA on health plan networks, and URAC on operational/utilization review. 


  • Our US-based credentialing specialists perform standard primary source verification (PSV) to NCQA ‍ ‍URAC or TJC standards. This typically takes anywhere from just a few days to several weeks to complete, depending on the response time from some of the primary sources.

    We also offer an Expedited PSV Service for emergency privileging and rapid candidate screening with a 48-hour turnaround.

  • Our US-based credentialing specialists perform standard primary source verification (PSV) to NCQA‍ ‍URAC‍ ‍or TJC standards.

    For tight hiring deadlines or emergency privileging, our Expedited PSV Service is built for rapid candidate screening with a 48-hour turnaround.

    Our Standard PSV service , which is more thorough, typically takes anywhere from just a few days to several weeks to complete, depending on the response time from the primary sources.

  • Payer enrollment is the process of registering a healthcare provider with an insurance plan so that they may bill and receive reimbursement for covered healthcare services. 

    The application process requires preparing and submitting information and credentials for the provider, which are then primary source verified by the payer to determine eligibility. 

    While many people associate "payer enrollment" with commercial health insurance networks (like Aetna or Blue Cross Blue Shield), it also includes government payers like Medicare and Medicaid. 

    Payer Enrollment is also called:

    • Provider Enrollment

    • Insurance Enrollment 

    • Health Plan Enrollment

    • Credentialing and Enrollment

    • Paneling / Joining a Panel

    • Payer Contracting 

    • EDI Enrollment (Electronic Data Interchange) 

    • Provider Data Management (PDM)

  • We offer our Payer (Insurance) Enrollment services for quick order on our website. If you have questions or you would like to explore which services or insurance companies would be best you can reach out to us via our secure online form or schedule a free consultation

  • We offer our Medicare Enrollment services for quick order on our website. If you have questions about this service or Medicare Enrollment before you order you can reach out to us via our secure online form or schedule a free consultation

    Due to the differences from state-to-state for Medicaid enrollment, our Medicaid services are only available after a free consultation at this time.

  • PECOS (Provider Enrollment, Chain, and Ownership System) is Medicare's online enrollment system used by providers and organizations to enroll in Medicare and manage enrollment information.


  • Yes. Our 360 Credentials + Compliance Service Subscription is a full-service, customizable solution. We proactively manage your ongoing renewals, NPI registrations, and profile maintenance. Explore our subscription plans on our website.

  • The 360 Credentials + Compliance Subscription provides ongoing credentialing and compliance support designed to help healthcare providers stay organized, maintain credentialing readiness, and navigate credentialing-related requirements with peace-of-mind. Specific subscription benefits are listed on the service page


  • You may cancel your subscription at any time before your next billing date. Cancellation prevents future recurring charges but does not typically result in a refund for subscription periods that have already been billed.

    Instructions for canceling your subscription are available here