Tips on Speeding Up the Nurse Practitioner Credentialing Process

The amount of paperwork required to start work as a nurse practitioner can be quite overwhelming. You’ve got a state license and a national certification. You have a DEA number and NPI number. There’s your diploma proving your educational qualifications and continuing education certificates indicating your continued compliance with certification guidelines. But, the paperwork doesn’t end there.

Once you are hired by an employer, the credentialing process begins. Credentialing is a process in which an organization or agency, for nurse practitioners typically government agencies like Medicare and insurance companies such as Blue Cross, collect and verify professional qualifications. You cannot be reimbursed (paid) by insurance companies or government agencies until the credentialing process is complete.

Submitting proof of licensure and certification to various insurance companies and government agencies and waiting for it to be processed can take weeks or even months. For many nurse practitioners, this process delays starting a new job. Fortunately, there are a few steps you can take to make the credentialing process run as smoothly as possible speeding up the arrival of your start date. ThriveAP Intern Stephanie Bauer has gathered the following tips.

1. Pull together your state licensure and certifications early in your job search

Credentialing companies will need to gather information from you regarding your qualifications to practice as a nurse practitioner. This includes documents like your diploma, certification, and state licenses. Having your proper documentation in order ahead of time will help speed this process.

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2. Assist with verification of education

Credentialing staff may need to contact schools you have attended to verify your educational qualifications. Make sure you have a copy of your diploma, and even a transcript on file. Obtaining these documents from you rather than waiting on an educational institution may expedited the credentialing process.

3. Prepare for verification of employment

Your previous employers, malpractice insurance carriers, and the National Practitioner DataBank will be contacted as one step in the credentialing process. Experts working in credentialing tell me they recommend maintaining a portfolio outlining your prior employers and malpractice carriers along with a document detailing your skill sets. This way, credentialing staff can go about verification in an organized, efficient manner.

4. Brace for a background check

Make sure you have the proper documentation gathered to fill out forms pertaining to background checks. Namely, this includes your social security card.

5. Round up a few references

Keep a current list of references at all times during your employment. Credentialing companies will contact your references directly, so warn those you name to expect a call or that they may be receiving paperwork to complete on your behalf. Make sure the phone number and email address you submit for each reference is current. This way credentialing staff don’t have to jump through hoops to get in touch with your references.

Neglecting to complete required forms thoroughly is the most common reason credentialing experts tell me the process is delayed. And, if providers are missing certain documents such as a social security card, a significant delay in credentialing may result. Follow up with the person heading your credentialing process on a regular basis to make sure things are running smoothly and that they don’t need anything further to complete the process.


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2 thoughts on “Tips on Speeding Up the Nurse Practitioner Credentialing Process”

  1. Hi, is there any regulation on starting employment prior to completion of credentialing process? e.g. shadowing only or working with a cosigner to sign off on plan

  2. Alethia,

    I have been allowed to shadow even before a collaboration agreement was in place. But I did not do anything an RN could not do, nor do anything with te patients except observe; I was just doing my OSHA (ec.) new-employee boring paperwork, attending file-specific training, getting to know my intended colaborator’s practice style and policies, and discussing cases.

    As a general comment, I would suggest people keep a copy of the first credentialing packet they ever submit and keep it up to date. You should have this in a folder along with the current CV, references, original diplomas, licenses/certification documents, and typed updates to every section. Run that entire folder through “scan to file” so that you have a digital copy of the entire folder, ready for any lost documents, new job credentialing, or other needs at a moment’s notice. You will be amazed at the difference such preparation makes, and you can smile instead of scream when you are called for something you’ve submitted twice already.

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