For many mental health providers, credentialing feels like a mysterious—and often frustrating—part of starting or growing a practice. But it’s also one of the most important steps in working with insurance companies. In this blog post, we’ll break down what credentialing actually is, why it matters, how the Council for Affordable Quality Healthcare (CAQH) fits into the process, and what clinicians can do to avoid unnecessary delays.

What Is Credentialing—and Why Does It Matter?

Credentialing is the process insurers use to verify that a clinician is fully qualified and legally allowed to treat their members. It’s not the same as getting licensed. By the time a provider is being credentialed, they’re already licensed—the insurance company is simply doing its own verification before allowing that clinician onto its panel.

Insurers typically confirm:

Education and training history
Active state license
Malpractice coverage
Practice locations and work history
Any legal or disciplinary issues

A provider cannot bill insurance or join a clinic’s existing insurance panel until they’re credentialed. That means delays can directly affect caseloads, revenue, and start dates for newly hired clinicians. Even in a well-established practice, every new provider must complete the credentialing process individually.

How CAQH Fits Into Credentialing

Before CAQH existed, clinicians had to fill out 40–50 pages of paperwork for each insurance company. CAQH changed that by creating a centralized database that insurers can pull from during credentialing.

Here’s how it works:

What CAQH Does

Stores all the foundational information insurers need
Standardizes data so clinicians don’t repeat applications
Serves as the source of truth insurers rely on

Creating a CAQH profile doesn’t automatically credential you, but without it, insurers have nothing to verify—and nothing can move forward.

What Clinicians Must Maintain in CAQH

Inside CAQH, providers must enter and regularly update:

Education and training history
License numbers and expiration dates
Malpractice insurance details
Practice, billing, and corporate addresses
Work history
Legal or disciplinary disclosures

CAQH also requires re-attestation every 90 days, which is simply confirming that the information is still accurate. If anything changes—even something small—clinicians must update it immediately. Insurers will reject or delay an application if they see mismatched or outdated information.

Common Mistakes That Delay Credentialing

Most credentialing delays come down to small errors that create big problems. Here are the issues that cause the most headaches:

Incorrect expiration dates — Even being off by a single day can trigger a full rejection.
Letting required documents lapse — If proof of license renewal, DEA registration renewal (for prescribers), or malpractice insurance renewal isn’t uploaded, the process stops immediately.
Incorrect practice addresses — CAQH requires multiple address types; mixing them up often leads to denials.
Typos across critical fields — Incorrect license numbers, misspelled names, or mismatched dates all raise red flags.
Failing to re-attest every 90 days — A “stale” CAQH profile can halt or reset the process.
Treating CAQH as set-and-forget — Even once credentialed, discrepancies will cause insurers to suspend you from their panels.

How Long Does Credentialing Take—and How Can Providers Speed It Up?

Actual credentialing timelines vary by insurer:

30–60 days for many plans
Up to 90 days for others
Longer when additional verification steps are required

Beginning January 1, 2026, California Assembly Bill 1041 (AB 1041) will require insurers to make a credentialing decision within 90 days of receiving a completed application. If the insurer missed that deadline, the provider must be provisionally approved for 120 days—unless disqualifying conditions apply, such as active disciplinary action or adverse NPDB reports. This timeline applies only to credentialing, not contracting.

You can read the full bill here:
https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260AB1041

How to Stay Compliant After You’re Credentialed

Whether you’re starting the credentialing process or maintaining your status afterward, the principles are the same: accuracy, organization, and consistency. Here’s what actually makes a difference:

Keep CAQH accurate and up to date — Even tiny errors can stall the process.
Re-attest every 90 days — This prevents the profile from going stale.
Track renewal dates closely — Upload updated licenses, DEA registrations, and malpractice certificates as soon as they renew.
Double-check all addresses — Ensure the practice, billing, and corporate addresses are entered correctly and consistently.
Start early for new hires — Avoid guaranteeing a start date until a few panels are confirmed.
Escalate when needed — Follow up regularly, request single-case agreements, or involve state regulators if delays become unreasonable.
Use experienced support — Clinics often avoid major problems by helping clinicians enter CAQH data correctly from the start.

Mental Health Business Moment of the Week

In this week’s business moment…

Tom shares a real situation from his clinic where a newly hired provider was credentialed with three insurance companies in about 60 days, which is considered pretty good, but ran into a major delay with a fourth insurer. That company repeatedly signaled that the provider was “almost ready,” only for Tom to discover that the initial 90-day waiting period wasn’t the credentialing timeline at all—it was just the wait to begin the process.

Once that period ended, the insurer informed him that the actual credentialing review would take another 90 days, leaving roughly 15 patients unable to schedule with the new provider. The experience highlights how unpredictable (and sometimes unreasonable) payer timelines can be, even when a clinic does everything right.

It also sets the stage for the upcoming 2026 law in California that will require insurers to complete credentialing within 90 days—or allow providers to begin seeing patients conditionally.

Conclusion

Credentialing may feel tedious, but it’s one of the most important steps in building a sustainable, insurance-based mental health practice. A clean, accurate CAQH profile, careful attention to expiration dates, and consistent maintenance can save clinicians months of delays—and protect your clinic from interruptions in care.

Whether you’re an individual provider or running a growing group practice, understanding the credentialing process gives you the power to start sooner, serve more patients, and stay ahead of administrative headaches.

Have a question or topic you’d like us to explore? Contact us at sitandstay@ripsytech.com.

And don’t forget to subscribe to the Sit and Stay Podcast for more insights on running a thriving mental health practice.

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A Practical Guide to Credentialing and CAQH for Mental Health Providers