5 Credentialing Mistakes That Could Be Costing You Thousands

 

Credentialing is a critical step for getting paid by insurance companies—but small mistakes can lead to major delays or denied claims. If you're handling your own applications, watch out for these 5 common errors that could be holding your practice back.

1. Using Outdated Applications

Payors often update their forms, but many providers unknowingly submit outdated versions. One wrong form can result in immediate denial. Always verify you're using the latest version—or leave it to a credentialing pro.

2. Incomplete or Inconsistent Info

A missing date, a mismatched NPI address, or an unchecked box can derail your entire submission. Accuracy is everything. Cross-check every field to avoid rejections.

3. Skipping CAQH Updates

Your CAQH profile should always be current and attested. Many payors rely on it first, and stale data can freeze your application in its tracks.

4. Ignoring Payor Follow-Ups

Submitting your application is only half the battle. If payors request clarification and no one responds, they’ll close the case. You need someone monitoring and responding promptly.

5. Missing Required Documents

One missing W-9, license, or malpractice certificate? Denied. Don’t assume everything’s attached—double check, every time.

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Avoid These Headaches with Sosa Practice Partners

Our credentialing experts know exactly what payors are looking for—and how to avoid costly mistakes. Let us handle it, so you can focus on your patients.

📞 800-482-8813
📧 info@sosapartners.com
🌐 www.sosapartners.com