Required Information for Credentialing

Credentialing is a detailed process that requires complete, accurate documentation from each provider and their practice. Submitting incomplete or inconsistent data can delay approval—or lead to denials. That’s why PractiCons offers a clearly defined checklist to help you gather all required credentialing materials in one place.

We’ve outlined all the essential documents and information needed for initial credentialing, re-credentialing, or payer revalidation.

Individual Provider Documentation

Please ensure the following items are submitted in full:

• CAQH ProView login and password

• Complete Curriculum Vitae (CV) – Must list all education and work history by month and year without gaps

• Medical License(s) – State licenses, DEA certificate, and State Controlled Substances (CDS) registration

• Board Certification(s) – Copies of any specialty boards

• Professional Liability Insurance Certificate – Showing current coverage

• Malpractice Documentation – Copies of any claims: settled, dismissed, or pending

• NPI Number & NPPES Login Info – Copy of NPI confirmation letter

• Social Security Card – For identity verification

• Diplomas – Including medical school and all postgraduate training (internship, residency, fellowship)

• CME Certificates – Showing recent continuing education

• Hospital Privileges Letters – Documentation of all current facility privileges

Group Practice Information

In addition to individual documents, please provide the following for your medical group:

• IRS Letter with Tax ID Number (TIN)

• Voided Check – For EFT enrollment

• Group NPI Letter and Login Info

• Business Contact Information – Including address, phone, fax

• Billing Contact Info – Name, email, and phone for billing department

PractiCons will use this information to accurately complete all credentialing and payer applications, ensuring timely submission and active enrollment. By having this documentation prepared and verified in advance, we can minimize errors and accelerate the approval process—so you get paid faster.

Need help collecting or updating these materials? Contact our credentialing team today. We’re here to make credentialing seamless.