Credentialing
Payer Enrollment Services: Get In-Network With Insurance Companies
Our payer enrollment services (provider enrollment and credentialing services) prepare, file and follow up each provider's applications, from the CAQH profile through each plan's credentialing and contract. No Florida statute gives commercial insurers or HMOs a deadline to credential you, or makes them pay retroactively for visits while you wait. What you control is a complete application, filed early.
The short answer
How do payer enrollment services work?
Five steps for each provider: one credentials file, a CAQH profile re-attested every 120 days, an application through each plan's own door, an answer to every request by its deadline, then the contract and the effective date. Published plan timelines run up to 90 calendar days. The Advixor Group prepares and files each application, answers every request for information and follows each one to a confirmed effective date.
SourcesDataSpring resources and FAQsUnitedHealthcare, Join our networkFlorida Blue provider manualEvernorth behavioral network
Five steps
How to get credentialed with insurance companies, step by step
Getting credentialed with insurance companies takes five steps, in this order.
- Build one credentials file. The core set: NPI and state license; a valid, unrestricted DEA registration if you prescribe; hospital privileges or a hospital coverage agreement; five years of work history, gaps of 6 months or more explained; a malpractice face sheet with limits and expiration date; a W-9 for each tax ID.
- Finish and attest your CAQH profile (CAQH is now DataSpring, powered by CAQH; same portal and login). It must be re-attested every 120 days, and neither the profile nor the NPI costs the provider anything (what credentialing costs). Setup and upkeep: CAQH and NPI.
- Apply through each plan’s own door, where the network is open (both below). Each door needs an account: UnitedHealthcare’s Onboard Pro runs on a One Healthcare ID; in Availity, Florida Blue makes whoever registers the administrator, and staff who update provider data need its Provider Data 720 role; Evernorth’s form needs the Contracting entitlement on the portal account. UnitedHealthcare starts counting only at a completed application with all required information.
- Answer every request by its deadline. If what Florida Blue verifies doesn’t match what you sent, the correction is due in writing by its date, and delays can close the application or end a contract. Status: Cigna at PSSCentral@Cigna.com (full name and TIN), Aetna at 1-800-353-1232, UnitedHealthcare on the Onboard Pro dashboard, Optum under Check Initial Credentialing Status, Florida Blue at 1-800-727-2227 after 90 days with no word.
- Sign the contract, then confirm the effective date. Approval and contract are separate steps, in each plan’s own order (last column of the table). Members count as in network only from the effective date the plan confirms; terms to check first: payer contracting.
What plans publish
Provider enrollment and credentialing, plan by plan
Credentialing with insurance companies, plan by plan: what each publishes for a practitioner joining its network, as of October 2026.
Florida Blue’s 30 business days is the letter after its credentialing committee decides; Evernorth’s 90 days is the whole process of joining. UnitedHealthcare’s two figures come from its join page and its Oct 14, 2026 FAQ: plan on the longer one.
| Plan | Where you apply | Plan-specific checks | Published timeline | After approval |
|---|---|---|---|---|
| Cigna (medical) | 1-800-88Cigna (882-4462), credentialing option; packet by email | CAQH status “Initial Profile Complete” or “Re-attestation” | 45–60 days | Email with your effective date; load typically within 10 business days |
| UnitedHealthcare | Onboard Pro (UnitedHealthcare Provider Portal) | Liability face sheet, CAQH ID, work and education history | Up to 45 calendar days or more (FAQ: 14) | Contract within 5 business days of the request (FAQ: 10); up to 60 days to load |
| Aetna | Online request for participation | CAQH kit within 10 business days; Aetna authorized in CAQH | None published | Written notice; contract finalized with network management |
| Florida Blue | Availity: Provider Registration Form, then Join our Network | CAQH currently attested; signed attestation within 180 days | Written decision within 30 business days | Florida Blue provider number |
| Humana | Its Medicare Advantage, Medicaid and military networks; it left employer-group commercial medical plans in 2025 | CAQH participation; 5 years of malpractice history (carrier or NPDB) | 30 calendar days from a complete application | Directory listing only after credentialing |
| Evernorth Behavioral Health | Provider Information Form, Evernorth Provider Portal, in one session | Independent license; W-9 per tax ID; CV within 2 years; you agree to participate at all your service locations | Up to 90 calendar days | Not published |
| Optum Behavioral Health | Join Our Network, Provider Express | CAQH matching your participation form | None published | Not published |
Sources each plan’s join page, FAQ or manual, and Humana’s 2023 announcement and 2025 Form 10-K, read Oct 17–19, 2026 (Official sources). Plans’ targets, not guarantees.
Closed networks
Getting on insurance panels when a network is closed
A panel is a plan’s network, and plans add providers by need: Aetna first weighs whether it needs more providers for its members in your area, and Florida Blue selects providers by its networks’ needs.
- UnitedHealthcare answers some requests with a “market is closed” letter. You can ask for a reassessment if you provide specialized care other local providers don’t, are acquiring a practice already in its network, or have another reason that may warrant one.
- Florida Blue posts a Network Status Table by service type. Some networks are closed or open only in limited areas, and the status changes, so recheck a closed one. Joining one Florida Blue network doesn’t put you in the others.
- Florida Medicaid plans don’t have to take every qualified provider (s. 409.907(13), F.S.), but a plan that declines you must give written notice of the reason (42 CFR 438.12(a)(1)). State enrollment comes first: Florida Medicaid enrollment.
Directories
Keeping payer enrollment current: changes, rosters and directories
Since January 1, 2022, federal law has required providers to send directory information to each commercial plan when a network agreement starts, ends or changes materially. Plans must verify directories at least every 90 days, update them within 2 business days of hearing from you, and keep a procedure for removing providers they cannot verify. Florida Blue has you validate 12 data points in Availity at least quarterly, from location, hours and panel status to languages, hospital privileges and covering physicians. Florida Medicaid plans check your record against AHCA’s Provider Master List. Each plan also recredentials on its own cycle, Florida Blue every three years: recredentialing. In CAQH’s September 2019 survey of 1,240 physician practices, the average practice held 20.2 plan contracts and spent at least one full staff day a week on directory upkeep, at $998.84 a month.
CMS checked 10,504 locations for 5,602 providers at 52 Medicare Advantage organizations and found at least one error at 48.74% of them; organizations ranged from 4.63% to 93.02%.
“An electronic provider directory must be updated no later than 30 calendar days after the MCO, PIHP, PAHP, or PCCM entity receives updated provider information.”
Source CMS, Online Provider Directory Review Report, Round 3 (Nov 28, 2018), Table 5. Specialty and name errors were under 0.5% each.
Who does what
What stays with you when you outsource payer enrollment
We plan which plans to join first, based on your patients and your market; prepare and file each application; answer every request for information; and follow each one to a decision, a signed agreement and a confirmed effective date. The credentialing package covers one tax ID (EIN) and up to five providers; more providers or tax IDs are priced on our fee schedule. We cannot guarantee acceptance, timing or rates: the plans decide.
One thing stays with your practice: the signatures. Each attestation and each participation agreement is yours to sign, and contract language goes to your own attorney.
What’s included
What our payer enrollment services include
CAQH and NPI
Build the CAQH profile plans pull your application from, ready for each provider to attest, and keep every NPI record current.
Learn moreMedicare enrollment
File the CMS-855I, reassign benefits to your group and confirm the effective date before you bill.
Learn moreFlorida Medicaid enrollment
Enroll each provider with Florida Medicaid, then join the health plans that serve Miami-Dade (Region I).
Learn morePayer contracting
Check rates, timely filing and termination terms in each participation agreement before you sign.
Learn moreRecredentialing
Track every re-attestation, recredentialing, revalidation and renewal date on one calendar.
Learn moreMental health credentialing
How therapists and psychiatric NPs enroll with Medicare, Florida Medicaid and the behavioral health networks.
Learn moreQuick answers
Payer enrollment services: what practices ask before joining a plan
How enrollment differs from credentialing, and how it works with Medicare, for therapists, in group practices and across state lines. Bring any other question to a consultation.
Is payer enrollment the same as credentialing?
How do I get credentialed with Medicare?
How do therapists and counselors get on insurance panels?
How does enrollment work for a group practice?
Can you enroll our providers with plans in other states?
Talk to an advisor
You care for patients. Who’s taking care of the business?
Tell us where your practice is today. We will tell you what we would do first.
Official sources
- Cigna, Health care provider credentialing, read Oct 19, 2026
- UnitedHealthcare, Join our network, read Oct 19, 2026; Credentialing FAQ, Oct 14, 2026, read Oct 17
- Aetna, Join the network, network FAQs and provider manual, June 2026, p. 58, read Oct 19, 2026
- Florida Blue, Provider Manual: Provider Participation, Sep 24, 2026, pp. 9–14, read Oct 19, 2026
- Humana, Credentialing and Recredentialing Policy, read Oct 17, 2026; exit from employer-group commercial medical plans, Feb 23, 2023, and Form 10-K for 2025, read Oct 19, 2026
- Evernorth, Join the behavioral network, and Optum, Individually credentialed clinicians, read Oct 19, 2026
- DataSpring, rebrand notice, June 7, 2026, resources and FAQs and 2019 practice survey, read Oct 17–19, 2026
- NPI final rule, 69 FR 3434, Jan 23, 2004 (no fee to be assigned an NPI, p. 3449), read Oct 19, 2026
- 42 U.S.C. 300gg-115 and 300gg-139, read Oct 17, 2026
- 42 CFR 438.10, 438.12, 424.516, 424.521 and 424.540, eCFR, read Oct 17–19, 2026
- CMS, Provider Directory Review Report, Round 3, Nov 28, 2018, read Oct 17, 2026
- AHCA, Florida Medicaid Provider Enrollment Policy, Feb 2026, read Oct 17, 2026; FLMMIS, Managed Care Registration and Provider Master List, read Oct 19, 2026
- Florida Statutes 2026, s. 409.907 and chapters 627 and 641, read Oct 17, 2026