Stay Compliant. Stay Credentialed. Stay Focused on Patient Care.
Recredentialing and CAQH maintenance are critical, ongoing responsibilities for any healthcare provider participating in insurance networks. Failure to keep up with these requirements can result in reimbursement delays, lost in-network status, or even a full panel termination—jeopardizing both your revenue and patient relationships.
At Pristinesolutions, we offer specialized support for Recredentialing and CAQH Profile Maintenance to keep your credentials current, your contracts active, and your practice running smoothly.
What is Recredentialing?
Recredentialing (also called revalidation or reappointment) is the process of renewing your participation in an insurance network. Most payers—including commercial insurers, Medicare, and Medicaid—require providers to recredential every 2 to 3 years to verify that their qualifications, license, and compliance status remain valid and up to date.
Our Recredentialing Services Include:
- Monitoring and tracking recredentialing due dates
- Updating professional and practice information
- Gathering required documentation (licenses, CEUs, insurance, etc.)
- Completing and submitting payer-specific recredentialing forms
- Coordinating with insurance carriers to confirm renewal
- Following up to ensure continued participation and prevent gaps
CAQH Profile Maintenance
The Council for Affordable Quality Healthcare (CAQH) is a centralized credentialing database used by most insurance companies to verify provider credentials. A current and accurate CAQH profile is mandatory for initial credentialing, recredentialing, and ongoing participation in many health plans.
We provide full CAQH Maintenance Services, including:
- Creating your initial CAQH profile
- Inputting and updating personal, professional, and practice details
- Uploading licenses, certifications, liability insurance, and other documentation
- Regularly reattesting your profile (every 120 days or as required)
- Monitoring for profile discrepancies or flagged issues
- Ensuring compliance with all payer-specific CAQH requirements
Our Provider Enrollment Services
Identification of Target Payers
We help you determine which insurance panels are most relevant for your specialty, location, and patient base—maximizing your potential reach and reimbursement.
Application Preparation and Submission
Our team gathers required documentation, completes payer-specific forms, and submits your applications accurately and promptly.
CAQH Profile Setup & Integration
For plans that rely on CAQH, we create or update your profile to ensure it aligns with enrollment requirements and avoids delays.
Follow-Up & Status Monitoring
We don’t stop at submission. We actively track application status, respond to payer requests for additional information, and expedite approval whenever possible.
Contract Review & Negotiation Guidance
Once approved, we help you review participation agreements, fee schedules, and reimbursement terms so you understand your rights and responsibilities before signing.
Who We Serve
Our provider enrollment services are ideal for:
- Independent Physicians and Specialists
- Nurse Practitioners and Physician Assistants
- Behavioral Health Providers (Therapists, Psychologists, Counselors)
- Physical Therapists, Chiropractors, and Dentists
- Group Practices and Multi-Specialty Clinics
Why Choose Pristonsolutions
Credentialing Expertise
Our dedicated credentialing team knows the ins and outs of recredentialing cycles, CAQH standards, and payer systems.
Deadline
Tracking
We stay on top of expiration dates so you don’t have to.
Faster
Turnaround
We avoid delays by ensuring accurate and timely submissions.
Risk
Reduction
Prevent costly gaps in insurance network participation.
Clear
Communication
We provide regular updates and full transparency throughout the process.
Trusted Partners
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