While credentialing typically occurs before a provider joins a network, re-credentialing is the periodic revalidation of an already credentialed provider. The purpose of provider re-credentialing is to ascertain if the provider continues to meet a payer\u2019s applicable credentialing, network participation, and regulatory requirements. <\/p>\n\n\n\n
Re-credentialing can determine a provider\u2019s participation status in payer networks and reimbursement eligibility. Therefore, if you are a credentialed provider and have received a written notice from the payer reminding you to re-credential with them, you must read this guide to mitigate risks and rejections. <\/p>\n\n\n\t\t\t\t