NO HIDDEN FEES

Complete Transparency

What you see is what you pay. No application fees, no processing charges, no surprise costs. Our package prices include everything needed for successful credentialing.

• ✓ All application fees included
• ✓ No processing charges
• ✓ No hidden administrative costs
• ✓ Clear, upfront pricing

MONEY-BACK GUARANTEE

Risk-Free Credentialing

If any insurance carrier rejects your application, we'll refund that portion of your fee. For example: if you choose our Professional Package ($500 for 3 carriers) and 1 gets rejected, you get $167 back.

• ✓ Partial refunds for rejected carriers
• ✓ Pro-rated refunds based on package price
• ✓ No questions asked policy
• ✓ Your success is our priority

EXAMPLE SCENARIO

How Refunds Work

Professional Package ($500 for 3 carriers):

• • 3 approved = You pay $500 (full price)
• • 2 approved, 1 rejected = You pay $333, get $167 back
• • 1 approved, 2 rejected = You pay $167, get $333 back

💡 Bottom Line: You only pay for successful credentialing!

Single Carrier Package

Perfect for new practitioners starting with one insurance carrier.

• ✓ 1 Commercial Insurance Carrier
• ✓ Complete Application Preparation
• ✓ Direct Submission & Follow-up
• ✓ Real-time Status Tracking

Professional Package

Our most popular choice for established practices looking to expand their insurance network coverage.

• ✓ 3 Commercial Insurance Carriers
• ✓ Complete Application Preparation
• ✓ Direct Submission & Follow-up
• ✓ Real-time Status Tracking

Enterprise Package

Comprehensive solution for large practices or providers seeking maximum insurance coverage.

• ✓ 6 Commercial Insurance Carriers
• ✓ Complete Application Preparation
• ✓ Direct Submission & Follow-up
• ✓ Real-time Status Tracking

Oregon, Washington & California Medicaid

Add Oregon Health Plan (OHP), Washington Apple Health, and California Medi-Cal (Medicaid) credentialing to any commercial package. Includes all required documentation and state-specific requirements.

• ✓ OHP, Apple Health & Medi-Cal Provider Enrollment
• ✓ State Medicaid Requirements
• ✓ Electronic Claims Setup
• ✓ Billing Guidelines Training

Coordinated Care Organizations (CCOs)

Add specific CCO networks to expand your Medicaid coverage. Each CCO requires separate credentialing with unique requirements.

• ✓ Individual CCO Applications
• ✓ Regional Network Access
• ✓ CCO-Specific Documentation
• ✓ Local Market Expertise

Real-Time Progress Tracking

Monitor your credentialing status across all insurance carriers with live updates. See exactly where you stand in the process with detailed progress indicators and estimated completion dates.

Direct Communication

Message our credentialing specialists directly through the portal. Get instant responses to your questions and receive personalized guidance throughout your credentialing journey.

Document Management

Upload, view, and manage all your credentialing documents securely. Our team can upload documents on your behalf, and you'll receive notifications when new documents are added.

Digital Signatures

Sign important documents electronically through our secure signature system. No more printing, signing, and scanning - complete everything digitally with just a few clicks.

Payment Processing

Handle all payments securely through our integrated payment system. View invoices, make payments, and track payment history all in one place.

Smart Notifications

Stay informed with automated notifications for status updates, document requests, payment reminders, and important deadlines. Never miss a critical step in your credentialing process.

Practice Information

• ✓ Practice location and address
• ✓ Tax ID number (EIN)
• ✓ National Provider Identifier (NPI)
• ✓ Malpractice insurance information
• ✓ State license number
• ✓ CAQH registration status

Professional Credentials

• ✓ Educational background and degrees
• ✓ Professional certifications
• ✓ Work history and experience

Required Documents

• ✓ Current state license
• ✓ Professional liability insurance certificate
• ✓ Additional carrier-specific forms

Commercial Insurance Carriers

Oregon, Washington & California Medicaid

Schedule a Call

(971) 303-3385

Speak directly with a credentialing specialist

Email Consultation

info@nwpsychologicalcredentialing.com

Get detailed answers to your questions

Request Information

Get Started

Complete credentialing guide and checklist

"NW Psychological Credentialing got me approved with 3 major Oregon carriers in just 8 weeks. Their local expertise saved me months of delays."

Result: 3 carriers approved in 8 weeks

"They helped me navigate both Oregon's CCO requirements and Washington's Apple Health system perfectly. I'm now serving Medicaid patients across both states."

Result: OHP + WA Apple Health approved

"Professional, responsive, and they know Oregon, Washington, and California insurance landscapes inside and out. My practice revenue increased 40% in 3 months."

Result: 40% revenue increase in 3 months

Portland Metro Area

Portland, Beaverton, Lake Oswego, Tigard, Milwaukie, Gresham, and surrounding communities. Our headquarters location with in-person consultation available.

Oregon Coast

Serving providers in Astoria, Seaside, Lincoln City, Newport, Florence, Coos Bay, and coastal communities throughout the region.

Central & Eastern Oregon

Bend, Redmond, Sisters, Baker City, La Grande, Pendleton, and rural communities. Specialized support for providers in underserved areas.

Willamette Valley

Salem, Eugene, Springfield, Corvallis, McMinnville, and valley communities. Strong relationships with regional insurance networks.

Southern Oregon

Medford, Ashland, Grants Pass, Klamath Falls, and southern communities. Experience with regional CCO requirements and processes.

Columbia River Gorge

Hood River, The Dalles, Cascade Locks, and gorge communities. Cross-state credentialing support for Washington border areas.

Washington State

Seattle, Spokane, Tacoma, Vancouver WA, Olympia, and communities throughout Washington. Specialized support for WA Apple Health and commercial carriers.

West Coast Cross-State

Supporting providers who practice in Oregon, Washington, and California. We understand the unique requirements for cross-state credentialing and compliance.

Application Submission

Complete and submit the insurance carrier's credentialing application with personal information, practice details, professional history, and required documentation. Applications can be submitted through CAQH ProView for many commercial carriers, or directly to the insurance company for Medicaid programs like Oregon Health Plan (OHP), Washington Apple Health, and California Medi-Cal.

Primary Source Verification

Insurance carriers verify information directly from original sources, including state licensing boards (Oregon Health Licensing Office, Washington Department of Health, California Board of Behavioral Sciences/Board of Psychology), educational institutions, previous employers, and malpractice insurance carriers. This verification process ensures accuracy and authenticity of all submitted information.

Credentialing Committee Review

A credentialing committee reviews your application, verified information, and supporting documents. They assess whether you meet the carrier's specific requirements and standards for network participation. This review typically takes 30-60 days for commercial carriers.

Approval or Additional Information Request

If approved, you'll receive notification and can begin accepting patients. If additional information is needed, the carrier will request clarification or additional documentation. Denials can occur if requirements aren't met, but can often be appealed with proper documentation and explanation.

Contracting & Enrollment

After approval, you'll receive a provider agreement to sign. Once executed, you'll be enrolled in the network and assigned a provider number. This allows you to bill the insurance carrier and receive reimbursement for covered services. You can then start accepting patients with that insurance.

Professional Documents

• Current state license(s)
• DEA certificate (if applicable)
• Board certification certificates
• Professional liability insurance certificate
• CV or professional resume

Educational Documents

• Diploma or degree verification
• Transcripts (sometimes required)
• Continuing education records
• Training certificates

Practice Information

• NPI (National Provider Identifier)
• Tax ID (EIN) or SSN
• Practice address and contact information
• W-9 form
• Office hours and availability

References & History

• Professional references (typically 2-3)
• Work history with dates
• Gap explanations (if applicable)
• Disciplinary action history (if any)

Oregon Requirements

Oregon Health Plan (OHP) - Medicaid:

• • Separate application from commercial carriers
• • Must be enrolled in Oregon Medicaid Provider Enrollment
• • CCO (Coordinated Care Organization) credentialing required for regional networks
• • Electronic claims submission setup required
• • Billing NPI and taxonomy codes must be verified

Oregon State Licensing:

• • Active, unrestricted license required
• • License verification through Oregon Health Licensing Office
• • Continuing education requirements must be current

Washington Requirements

Apple Health (Medicaid):

• • Washington State Health Care Authority enrollment
• • Managed care organization (MCO) credentialing may be required
• • ProviderOne system registration
• • Electronic claims submission setup
• • Regional network requirements vary by area

Washington State Licensing:

• • Active, unrestricted license from Washington Department of Health
• • License verification through state database
• • Continuing education compliance required

California Requirements

Medi-Cal (Medicaid):

• • California Department of Health Care Services (DHCS) enrollment
• • Managed care plan (MCP) credentialing required for regional networks
• • Medi-Cal Provider Enrollment Division (PED) registration
• • Electronic claims submission setup required
• • Billing NPI and taxonomy codes must be verified

California State Licensing:

• • Active, unrestricted license from California Board of Behavioral Sciences or Board of Psychology
• • License verification through state licensing board
• • Continuing education compliance required

Fastest: 30-60 Days

When all documents are complete, CAQH is current, and there are no issues requiring additional information. Some carriers can process faster, but this is the exception rather than the rule.

Typical: 60-90 Days

Most commercial carriers process applications within 60-90 days when documentation is complete and accurate. This accounts for verification processes and committee review schedules.

Complex Cases: 90-180 Days

Medicaid programs, applications requiring additional documentation, or cases with complex practice structures may take 90-180 days. Multiple follow-ups may be necessary.

Challenge: Incomplete Applications

Solution: Double-check all required fields before submission. Use a checklist and ensure all documents are current (within 30-60 days for most carriers). Have a credentialing specialist review your application before submission.

Challenge: CAQH Re-attestation Lapses

Solution: Set calendar reminders for CAQH re-attestation (every 90-120 days). Update information immediately when changes occur. Consider using a credentialing service to manage re-attestations.

Challenge: Delayed Responses

Solution: Follow up regularly (every 2-3 weeks) with carriers. Document all communications. Consider having a credentialing specialist handle follow-ups, as they understand carrier processes and can navigate systems more efficiently.

Challenge: Missing or Expired Documents

Solution: Maintain a credentialing file with all documents organized. Set renewal reminders for licenses, malpractice insurance, and certifications. Keep digital copies readily accessible.

Challenge: Practice Structure Complexity

Solution: Group practices, multiple locations, or complex ownership structures require additional documentation. Work with someone experienced in these scenarios to ensure all requirements are met.

Challenge: State-Specific Requirements

Solution: Oregon, Washington, and California have unique Medicaid requirements (OHP, CCOs, Apple Health, Medi-Cal). Work with credentialing specialists familiar with West Coast requirements to navigate these efficiently.

Q: How long does credentialing take?

A: Most commercial carriers process applications in 60-90 days when documentation is complete. Medicaid programs (OHP, Apple Health) may take 90-180 days. Factors affecting timeline include application completeness, carrier processing times, and response to additional information requests.

Q: Do I need to be credentialed with each insurance carrier separately?

A: Yes, each insurance carrier requires a separate credentialing process. However, many commercial carriers use CAQH, which allows you to complete one application that multiple carriers can access. Medicaid programs (OHP, Apple Health) require separate applications.

Q: What is CAQH and do I need it?

A: CAQH ProView is a universal credentialing database used by many commercial insurance carriers. While not required for all carriers, it's highly recommended as it streamlines the credentialing process for multiple carriers. You must re-attest every 90-120 days to keep your information current.

Q: Can I start seeing patients before credentialing is complete?

A: No, you cannot bill insurance carriers or receive reimbursement until you are fully credentialed and have signed a provider agreement. However, you can see self-pay patients or patients with insurance you're already credentialed with.

Q: What happens if my application is denied?

A: Denials can often be appealed. Common reasons for denial include incomplete applications, expired licenses, or failure to meet specific carrier requirements. Review the denial reason, address any issues, and submit an appeal with additional documentation if needed.

Q: Do I need to re-credential periodically?

A: Yes, most carriers require re-credentialing every 2-3 years. You'll also need to update your information when licenses, malpractice insurance, or other credentials are renewed. CAQH requires re-attestation every 90-120 days.

Q: What's the difference between credentialing and contracting?

A: Credentialing is the verification process that determines if you meet a carrier's requirements. Contracting is signing the provider agreement that establishes payment rates and terms. Credentialing must be completed before contracting can occur.