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Re-credentialing & revalidation, without the lapses
Keep CAQH, payer and Medicare cycles on one calendar, with documents refreshed and submissions followed up, so participation never quietly expires.
Why renewals deserve their own process
Getting into a payer network is only the first half of the job. Payers re-verify participating providers on a schedule, Medicare and Medicaid revalidate enrollment, and CAQH profiles must be re-attested again and again. Each of these has its own clock, its own notice and its own deadline.
Revaynt Healthcare tracks those clocks for the providers and payers assigned to us, prepares the updated documents and submissions, follows up with payers and keeps a record of what was filed and what each payer confirmed. The goal is simple: renewals that happen on time, with no surprises.
Missing a renewal can lead to delays, a suspended listing or the need to re-apply. Network acceptance and processing timelines always remain subject to payer decisions.
Several clocks, running at once
A single provider can have a CAQH deadline, two or three payer cycles and a Medicare date all running in the same year. The timeline below shows how they overlap.
CAQH re-attestation
Profiles are generally re-attested about every 120 days. A profile that has lapsed can block payers from accessing it, which stalls both new applications and renewals.
Payer re-credentialing
Commercial payers commonly re-verify providers every two to three years. Plans that follow NCQA standards re-credential at least every 36 months, counted from the last decision.
Medicare and Medicaid
Medicare enrollment is generally revalidated about every five years, with some supplier types on shorter cycles. Medicaid timing is set by each state.
Cycle lengths shown are typical, not universal. Always confirm the cycle and due date directly with each payer, and make sure notices reach a contact who is actually monitoring them.
What a renewal usually needs
Requirements vary by payer, but most renewals draw on the same core documents. Having them organized in advance is the single biggest time-saver.
Provider documents
- State license(s) and expiry dates
- DEA and state controlled-substance registrations, where applicable
- Board certification or equivalent
- Current malpractice insurance certificate
- Up-to-date CV with any gaps explained
- NPI and other identifiers on file
Practice details
- Practice addresses and service locations
- Tax identification and group affiliation details
- Hospital privileges or covering arrangements, where applicable
- Billing and payment contacts
- Authorized contact for payer notices
- Signed authorizations for CAQH and payer portals
What we do for each renewal
Renewal calendar and tracker
We build one tracker for assigned providers and payers: due dates, notice dates, submission references and payer-confirmed effective dates.
Early outreach
Work starts well before a deadline, with the lead time agreed in your scope, so documents and signatures are never a last-minute scramble.
Document refresh
We collect and review licenses, certifications, insurance certificates and other supporting documents for completeness and flag anything expiring.
CAQH updates and attestation coordination
We help prepare profile updates and coordinate attestation, following the account owner’s authorization requirements.
Practice and demographic updates
Changes to addresses, locations, affiliations and group details are coordinated with the payers affected, within the agreed scope.
Follow-up and confirmation
We follow up on submissions, answer payer requests for more information and record what each payer confirms.
How a renewal runs
Five steps, repeated for every cycle.
Inventory participation
List every payer, plan and program each provider participates in, with dates and contacts.
Build the calendar
Map every cycle and deadline and set reminders ahead of each one.
Refresh documents
Collect current documents, check completeness and coordinate missing items.
Submit and follow up
Prepare and send the renewal or revalidation, then track payer requests and responses.
Confirm and record
Capture confirmations, effective dates and next due dates in the tracker.
What stays with you and with the payer
- Attestation is the provider’s own confirmation; we coordinate it within the account owner’s authorization requirements.
- Payers decide on participation and set their own processing timelines.
- Providers supply accurate documents and keep notice contacts current.
- Bank details and financial authorization remain under the practice’s control.
Network acceptance and processing timelines remain subject to payer decisions.
Frequently asked questions
How far ahead should re-credentialing start?
As early as your scope allows. Payers can take weeks or months to process submissions, and documents such as licenses or insurance certificates sometimes need to be renewed first. We agree a lead time with you and track it per payer.
What happens if a deadline is missed?
Outcomes depend on the payer and program. A late renewal can mean delayed processing, a suspended participation status or having to re-apply, which can interrupt in-network payment. Preventing that is the purpose of the tracker.
Is CAQH attestation the same as re-credentialing?
No. CAQH attestation confirms that your profile is accurate and current, and it is repeated frequently. Payer re-credentialing is each payer’s own re-verification of your credentials, on its own cycle. Medicare revalidation is separate again.
Can you sign or attest on our behalf?
Attestation is the provider’s own confirmation. We prepare updates and coordinate attestation, and we follow the account owner’s authorization requirements.
Do you handle practice changes such as a new address or location?
Yes, within the agreed scope. Changes to addresses, practice locations, affiliations and other demographic information are coordinated with the payers affected.
Can you track providers we have already credentialed ourselves?
Yes. We begin by inventorying current participation, then build the calendar from that point.
Do you know when your next renewal is due?
Tell us which providers and payers you work with and we will discuss how to put every renewal on one calendar.