NCQA-Certified Credentialing Program

Medical credentialing is a very thorough and lengthy procedure. TXCIN offers an NCQA-Certified Credentialing Program and is delegated by health plans to be the credentialing agent on record.

The Process

Complete Your Profile

To become a credentialed physician, nurse practitioner, or certified physician assistant, the applicant must complete a CAQH profile with current documentation and attestation.

Group Peer Review

Within 35 days of submitting the completed application with appropriate documentation, the physician’s or AP’s application is presented to the TXCIN’s Group Peer Review and Membership Committees. The application is either approved or rejected at this time, and the outcome is further presented to TXCIN’s Board of Directors.

Choose Your Contracts

Once the physician or AP is approved, their Physician Service Account Manager delivers an opt-in/opt-out packet so the provider may select the contracts in which to participate. Once the physician or AP information is submitted to the health plans, an effective date is granted by the plan/payer.

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