4 ways to avoid enrollment delays with private plans that don’t use UPD

Why This Topic Matters

Enrollment delays can disrupt provider onboarding and revenue flow. Understanding how different private payers handle credentialing helps staff prepare the right documentation and timelines.

Article Sections

1. Use UPD whenever you can

   Introduces the CAQH UPD service and explains its role in private payer credentialing. Discusses why some plans participate and others may not.

2. Ways to streamline enrollment when a payer does not participate

   Outlines general workflow adjustments for practices that need to complete enrollment without an online datasource. Covers paperwork handling, validation follow-up, and advance planning.

3. 1. Ask the payer whether a UPD printout is acceptable

   Describes checking with a payer about whether a printed UPD form can be used instead of a separate enrollment form.

4. 2. Do the prep work for a paper process

   Covers preparation for manual completion of payer and privileging paperwork when online submission is unavailable.

5. 3. Be alert for validation requests

   Addresses follow-up requests from payers to confirm or supplement provider information and the need to respond promptly.

6. 4. Begin the process early and plan provider start dates

   Focuses on enrollment timing considerations and coordinating credentialing completion with provider start dates.