Every day your providers aren't in-network, you're losing significant revenue.
We help healthcare organizations build audit-ready delegated credentialing programs that cut payer onboarding from 6 months to days — and keep your revenue flowing.
Delegated Credentialing Expertise
Whether you are building a delegated credentialing infrastructure from the ground up or improving an existing program, we partner with healthcare organizations, payers, and CVOs to strengthen operations, support growth, and achieve long-term success.
25+ Years of Experience including Senior Leadership and NCQA Surveyors
800+ Delegates Managed at Aetna
Provider onboarding shorten from Months to as fast at 5 Days
100% of NCQA and Payer Audits passed
Services to Get You Onboarded Quicker
With over a decade-long affiliation with national NCQA credentialing organizations, our services are tailored to offer top-notch solutions to your healthcare, CVO, or payer organization.
Results Our Clients Have Experienced
Kandi is one of the most knowledgeable professionals in healthcare credentialing and compliance that I know. There is no other consultant in the space I would recommend more highly — her knowledge, expertise, responsiveness, and results make her among the best there is.
Working with Delegated Credentialing Pros to build our program was a truly positive experience. With a network of over 3,000 providers, we knew it was a big undertaking — her guidance made all the difference. She helped us build a program that feels strong, compliant, and sustainable.
Kandi was instrumental in educating our team on NCQA requirements, establishing credentialing policies, procedures and committee structures, and guiding our transition from an outsourced function to a fully functional internal department. We could not have done this without her guidance.
About Delegated Credentialing Pro's
Delegated Credentialing Pros partners with healthcare organizations, payers, and CVOs to build NCQA-compliant credentialing programs that cut payer onboarding delays and accelerate revenue — so your providers get to work faster and your operations scale without limits. We tailor every program to your workflows, keeping you compliant today and positioned for sustainable growth tomorrow. We also advise on provider data end to end activities to support compliance with claims and directory.
What is delegated credentialing?
Delegated Credentialing is when a payer delegates the authority to perform credentialing functions on their behalf.
What is the advantage of delegated credentialing?
Having delegated agreements with payers puts you in the driver’s seat. You no longer have to wait for enrollment applications to be processed taking upwards of 6 months at times. You can have a providers effective date with those payers the date that your organization completes and approves the files. This means your providers can start seeing in network patients in as little as days instead of months.
What do I need to have in place to begin pursuing delegated credentialing audits with payers?
You will need to have policies and procedures that meet NCQA/URAC, state and federal guidelines. You will need to have evidence (minutes, monitoring logs, provider files) to validate that you are following all policies and procedures.
How long does it take to establish a delegated credentialing program?
This all depends on how you plan to operationalize your process. I have worked with clients that are up and running and ready for payer audits in as little as 6 months.
What are the basic requirements to achieve delegated credentialing with payers?
You should have a group or national agreement with payers or be moving to group or national contracts. Your organization should have at least 100 providers. You must have an operational delegated credentialing program in place for a period of time which is typically a minimum of 6 months to a year. Each payer has their own set of requirements outside of that on how long your program has been in place or how many providers but this has been found to be standard practice.
What type of companies do you work with?
– Healthcare Organizations scaling to or having over 100 providers- start-up and existing operations
– Health Plans
– CVO’sHow do you work with payers?
We work with payers for the same NCQA credentialing needs as well as provider life cycle management. This includes working with your team(s) to ensure data is correctly moving to and between each department, and the downflow of credentialing data is current in directories.
Ready to Build a Program That Actually Supports Your Growth?
Schedule a free discovery call with Kandi to talk through your current state, your goals, and what it would take to get you there.
