Provider Credentialing in California
A new MD who can't bill Medi-Cal or Anthem for four months isn't "pending." That's payroll with no offset. We run California provider credentialing in parallel tracks — CAQH hygiene first, then PECOS, Medi-Cal, and commercials — so first-billable dates arrive sooner than the sequential slog most offices still use.
What's included
- CAQH ProView cleanup and quarterly attestations
- Medi-Cal provider enrollment and plan linkages
- Medicare PECOS and Medicare Advantage panel adds
- Commercial applications filed in complexity waves, not alphabetical order
- Re-credentialing started 120 days before expiration
How it works
- 1
Document intake
License, DEA, malpractice face sheet with history, CV, board certs, W-9 — one secure packet.
- 2
CAQH & PECOS
Attest, upload, and clear OIG/SAM before any payer packet leaves.
- 3
Medi-Cal + commercials
State enrollment and commercial apps run side by side, not end to end.
- 4
Follow-through
Weekly payer calls until the effective date is in writing.
California credentialing fails in predictable places. Expired CAQH attestation. Incomplete malpractice history. A Medi-Cal application that sat because nobody called after week three. We've seen clinics wait 120 days for work that should have been 45 with parallel filing.
Start Medi-Cal the same week you start CAQH
Medi-Cal timelines don't care that your commercial panels aren't done. File early. Keep a named contact on every cover letter. Ask for written effective dates — and backdating to the application date when the plan allows it.
Re-credentialing is where California groups get blindsided. We calendar 120 days out so panels don't lapse mid-quarter while someone "meant to get to it."
FAQs
- Do you enroll providers into Managed Medi-Cal plans?
- Yes. We handle fee-for-service Medi-Cal enrollment and the managed-care plan linkages your counties require.
- Can you rescue a stalled Anthem or United application?
- Often. We audit the CAQH pull, fix the rejection reason, and restart with a complete packet — not another blind upload.