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States’ Efforts Help To Streamline the Provider Enrollment Process


You know how long it takes to receiver payer enrollment approvals from health plans to which you have applied. The enrollment process averages 90 to 120 days, with some health plans taking even longer. 

The lengthy approval process can delay access to care as patients are unable to get services from those providers who are not yet authorized. Physician reimbursement shortfalls may also result when providers are ineligible for health plan reimbursement.

States Working To Streamline and Accelerate the Provider Enrollment Process

Earlier we reported on the successful attempts of Texas and Arizona to reduce the time it takes for health plan provider enrollment. 

These states used tactics such as requiring that credentialing be completed in 100 days or streamlining the Medicaid application process so that one application can be used for the 19 state plans.

With these innovations, some states are focusing on accelerating the provider enrollment process so that their residents can get care quickly from qualified providers. 

State-Specific Payer Enrollment Improvements Are Models for Others

The successful efforts of both Texas and Arizona in improving the payer enrollment process for health care providers serve as positive examples for other states, according to a recent article in

These improvements will also serve as an impetus to industry reform. CAQH is working on rules and standards for electronic communications that will help streamline events like payer disenrollment. Until process improvements are ready to roll out, health care providers should be proactive with payer enrollment tasks. 

Also, consider going paperless if your organization is not yet fully automated. Many providers still rely on manual processes and data collection. An automated system that tracks and manages enrollment applications can significantly reduce the paperwork and time required for payer enrollment. 

Stay tuned for more payer enrollment improvement news. These changes help health care providers put patients first, not paperwork!

Let Us Manage All Your Payer Enrollment Services

If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.

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