Sample Credentialing Tracker
Every provider, every payer: enrollment status, effective dates and revalidation due dates. Fictional practice, illustrative numbers.
Fictional practice. All figures are illustrative.
SAMPLE / DEMONSTRATION DATA. This report describes a fictional practice. It is not a real client.
This tracker is a demonstration, not a client result. See credentialing services for the service and pricing for how credentialing is included. Request a free practice audit or contact the team to ask about your own enrollments. Do not send patient records with that request.
1. Enrollment status
| Provider | Payer | Status | Owner | Submitted | Effective date | Dependency | Follow-up |
|---|---|---|---|---|---|---|---|
| Provider A | Medicare (PECOS) | Approved | SFA credentialing | Jun 3 | Jul 1 | None | None until revalidation |
| Provider A | Commercial plan 1 | In review | SFA credentialing | Jul 15 | Not set | Payer review | Oct 15 |
| Provider C (NP) | Medicaid | Approved | SFA credentialing | May 20 | Jun 1 | None | None |
| Provider C (NP) | Commercial plan 2 | Pending info | Practice | Aug 2 | Not set | Collaborative agreement | Practice sends the agreement, then SFA resubmits |
| Provider D | Medicare Advantage plan | Not started | Practice | Not submitted | Not set | CAQH attestation | Start after the attestation |
2. Upcoming due dates
| Item | Provider | Owner | Due | Dependency |
|---|---|---|---|---|
| CAQH re-attestation | Provider B | Practice | Nov 12 | Completed attestation |
| Medicare revalidation | Provider A | SFA credentialing | Feb 2027 | PECOS notice |
| State license renewal | Provider D | Practice | Mar 2027 | Renewal application |
| Malpractice certificate | All | Practice | Jan 1 | Current certificate |
Benchmarks are common industry targets, not guarantees. Results vary by practice, specialty, payer mix, claim volume, billing history and documentation.
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