Most small practices run credentialing on spreadsheets and Outlook reminders — until a provider's CAQH attestation lapses, payers quietly drop them from the roster, and claims start rejecting weeks before anyone notices. This agent runs the credentialing workflow so your practice manager doesn't have to. ## What's included - **Provider credential tracking** — licenses, DEA registrations, board certifications, malpractice COI, CAQH attestation cycles - **Multi-stage alerts** — 90d / 30d / 7d / EXPIRED for every credential - **NPI verification** — automatic against CMS NPPES registry - **Monthly OIG/SAM exclusion screening** — required for Medicare/Medicaid participation; runs across your full provider panel - **Locum credentialing packets** — minutes instead of hours - **Per-payer enrollment status** — BCBS, UHC, Aetna, Medicare, Medicaid: enrollment status, re-cred cycle dates, in-process application timelines - **90-day-before re-cred window alerts** so applications go out in time - **New provider onboarding** — pulls NPI data automatically, builds credentialing checklist for their specialty - **Day-one urgency flag** — new providers cannot bill payers retroactively; credentialing must start on day one - **CAQH attestation cycle tracking** — alerts before lapses cause silent payer drops ## Limitations - **Not a CVO replacement** — workflow + deadline tracking; if you need full credentials verification organization service, hire one - **Not legal counsel** — credentialing decisions remain with your governing body - **Not a payer portal integration** — generates application data; you submit via each payer's portal - **Not an EHR / billing platform** — pairs with athenahealth / Epic / DrChrono / Kareo - **U.S.-payer-focused** — Canadian + UK + AU credentialing regimes entirely different ## Best fit Solo + small healthcare practices (1-15 providers) managing commercial + government payer credentialing. Especially valuable for practice administrators who run credentialing alongside 20 other responsibilities — one prevented CAQH lapse that would have caused $15-50K in rejected claims pays for the agent many times over.
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