Frequently Asked Questions

  • Credentialing is the process of verifying a provider’s education, training, license and professional history. It isn’t just bureaucratic busywork—credentialing exists to protect patients by ensuring practitioners are qualified to provide care. Without credentialing, unqualified individuals could slip through the cracks. From a provider’s perspective, credentialing also keeps you in compliance with insurers and regulatory bodies, reduces legal risk and boosts patient trust.

  • Patience is a virtue here. For most commercial insurance plans, the credentialing and contracting process takes roughly 90–120 days, although some carriers process applications faster and others can take longer. Medicare enrollments are often completed in about 60–90 days. Factors like missing documents, specialty type and carrier workload can stretch timelines beyond the norm. AlignNet keeps things moving—but we can’t override an insurer’s internal clocks!

  • Start yesterday. We cannot stress this enough! AlignNet recommends beginning the process as soon as you have your state license number and definitely before your first job starts. Even though you cannot get credentialed UNTIL you are hired, all the prep work can be done and all that is left is to submit the paperwork. Credentialing can take 30–120+ days depending on the carrier and state, so prepping during your last semester or immediately after accepting an offer helps ensure you’re billing from day one.

  • Expect to supply a stack of paperwork. Core items typically include your state license, malpractice insurance certificate, DEA certificate, board certifications, diplomas, CV (with month/year format), IRS Form W‑9 and government-issued ID. Depending on your situation, you may also need an ECFMG certificate, passport or citizenship papers, collaborative agreement (for nurse practitioners), admitting arrangement letters, business licenses, and EIN verification documents. Providing complete, accurate documentation up front reduces delays.

  • Yes. Most carriers require a real service location—home addresses usually won’t cut it. You can use your home as a billing or correspondence address, but you must list the physical address where you’ll see patients. Medicare allows you to submit enrollment applications up to 60 days before you start seeing patients at a new location.

  • Yes and no. Not for in‑network rates. Until credentialing and contracting are complete, you’re considered “out of network.” You might bill, but patients could be responsible for the entire charge, and insurers generally won’t pay at in‑network rates until you’re officially approved and have an effective date.

  • Absolutely. We set up and maintain your CAQH profile, obtain or update NPI numbers, assist with DEA registration and track expirations so you stay compliant. For private practices, we also help obtain group NPIs and manage multiple locations.

  • Yes. AlignNet supports credentialing with Medicare, Medicaid and commercial plans. Medicaid enrollment and state-specific guidance are available as add‑on services.

  • AlignNet’s transparent pricing lets you pick what you need without surprises:

    • Essential Credentialing: starting at $350 for solo providers or small teams. Includes a dedicated specialist, CAQH updates, weekly status reports and enrollment with two PPO plans.

    • New Graduate Bundle: starting at $495. Designed for new grads, including full CAQH setup, NPI/DEA help, Medicaid tips and weekly updates.

    • Group/DSO Enrollment: custom packages for three or more providers, with volume‑based pricing and multi-location coordination.

    • Monthly Maintenance Plan: starting at $95 per provider. This required plan covers CAQH attestations, recredentialing reminders, roster updates and unlimited profile edits.

    • Add-On Services: Medicaid enrollment, state license applications, NPI/DEA registration, fee schedule updates, file conversions and Spanish-language onboarding.

    See our Pricing page for more details.

  • One of the most common misconceptions is that once the contracts are signed, it’s all done. Credentialing isn’t a “set it and forget it” process. Payers require periodic recredentialing, licenses and malpractice insurance expire, and CAQH attestation must be updated regularly. AlignNet’s maintenance plan handles these tasks—tracking expiration dates, submitting updates and ensuring you don’t miss critical deadlines.

  • Credentialing is tedious, and errors lead to delays. AlignNet offers flat‑rate packages, dedicated specialists and expertise in dental and medical credentialing. While we can’t make insurers work faster, we prevent common mistakes that derail applications. One credentialing application for one provider can take up to 40 hours of work from start to finish and let’s face it, that time could be much better served providing care to your patients rather than having staff buried in the paperwork. You’ll have a single point of contact, clear communication and a boutique feel with big‑business results.

  • Yes—we love helping new grads. Our New Graduate Bundle includes credentialing with two PPO plans, CAQH and NPI setup, DEA support, Medicaid guidance and weekly progress updates. We recommend starting the process during your last semester or right after you accept your job offer.

  • Definitely. AlignNet’s DSO/Group Practice solutions support credentialing for multiple providers across multiple locations, including Medicare, Medicaid and commercial plans; CAQH and NPI management; DEA registration; recredentialing; and customized reporting. We coordinate with your operations team to track timelines and keep everyone in the loop.

  • Yes. Whether you’re opening a solo practice or expanding a group, AlignNet assists with new practice credentialing, payer enrollment, recredentialing and practice location setup. Our add‑on services cover DEA registration, license verification and payer directory cleanup.

  • We can credential with any insurance you would like to be in network with.

    Some examples of typical insurances/networks are:

    Major Insurance Carriers

    • Aetna

    • Ameritas

    • Anthem / Blue Cross Blue Shield

    • Cigna

    • Delta Dental

    • Dental Health Alliance / Sun Life

    • Dominion National

    • Guardian

    • Humana

    • Medical Mutual of Ohio

    • Medicaid

    • Medicare

    • MetLife

    • Molina Healthcare

    • Mutual of Omaha

    • Principal

    • Quartz (formerly Unity)

    • TRICARE

    • TruAssure

    • United Concordia

    • UnitedHealthcare (UHC)

    • WEA (Wisconsin Education Association)

    Common Networks

    • Blue Cross Blue Shield Network (including Anthem and Elevance Health plans)

    • Careington Platinum Network

    • Cigna PPO/Radius Network

    • Delta Dental Networks (Premier, PPO, and Medicare Advantage)

    • Dental Health Alliance Network (Sun Life)

    • Dentemax Network (used by carriers such as Always Care Benefits, Argus, Dominion National, Medical Mutual of Ohio, Mutual of Omaha and TruAssure)

    • Guardian DentalGuard PPO Network

    • The Alliance Network

    • Quartz Network

    • TRICARE Network

    • UHC Network (UnitedHealthcare)

    • WEA Network

    If you have one that isn’t listed, no worries! We can find out what they need for credentialing as well.

  • Getting started is easy—just fill out our secure onboarding form, email us at info@alignnethealth.com or call 844‑ALIGN24. We’ll gather your information, prepare applications and track the process so you can focus on patient care.

Need something not covered here? Reach out—we’re happy to answer any questions, entertain long‑shot scenarios and help you get credentialed without losing your sanity.