Chiropractor’s Guide to Credentialing with Insurance Companies

Getting credentialed with insurance providers can be a hassle. But if you ever hope to build your clinic and make care more accessible to your patients, it's something that's worth doing.

Credentialing is how insurance firms verify your credentials. It's what allows you to charge them for patient visits. It's different from contracting because the credentialing is first. Contracting follows when they've approved you and you're prepared to negotiate payment terms.

You must do this section correctly. Errors can hold things up or prevent you from being on the panel at all.

I’ve broken the process into six clear steps. These are the same steps we’ve walked through with other clinics, and they work.

Let’s walk through them together.

Breakdown of Credentialing with Insurance Companies

These are the same steps chiropractors follow when they want to get approved by insurance panels. Follow them in order and take your time with each one. It’ll save you from back-and-forth later.

Step 1: Choose the Right Insurance Panels

Start by deciding which insurance companies you want to work with. Don’t try to get credentialed with every payer. Focus on the ones that actually matter for your clinic.

Ask your patients about their insurance coverage and look at the top insurers in your area. Talk to other chiropractors near you and ask what plans they work with and which ones they avoid.

Check the basics:

• How many of your patients use this plan?
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• What are the reimbursement rates like?
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• Do they pay on time?
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• Are their chiropractic policies easy to work with?

Some plans are worth it and some will make you jump through hoops and delay payments. It’s better to work with four good plans than ten bad ones.

Bonus read: What's the Best Business Model for Your Chiropractic Practice?

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Step 2: Get Your Documents in Order

Insurance companies want to see your credentials before they let you in. They all ask for pretty much the same documents, so you can prep once and use them again and again.

Here’s what you’ll need:

• Active chiropractic license
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• NPI number
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• Malpractice insurance certificate
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• CV or resume with work history
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• School diploma or transcripts
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• W9 form
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• EFT form for direct deposit
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• DEA registration if applicable

Put all of these into one folder and save them digitally and label the files clearly. Something like “DrJones_License_2025.pdf” works well. If something’s about to expire, renew it before you apply.

You should also double-check the details. Insurers will compare your documents against your application and your CAQH profile and everything has to match.

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Also read: Chiropractic License & Certification Guide: What You Need to Know

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Step 3: Set Up Your CAQH Profile

Most insurance companies use the Council for Affordable Quality Healthcare (CAQH) for their Chiropractors credentialing services. It’s where you create a central profile with all your professional details and upload your documents.

• Start by going to the CAQH ProView website and creating an account. 
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• Take your time filling it out. Everything needs to be complete and accurate. 
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• Use the same address, phone number, and other details that you put on your insurance applications. 
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• Keep your license and malpractice insurance up to date in there too.

Once your profile is filled out, you’ll need to “attest” it. That just means confirming all the info is current. You have to do this every 120 days. If you miss that, your profile goes inactive and insurance companies will stop reviewing it.

Set a reminder in your Google Calendar so you don’t forget. If you're using Noterro, a clinic management software, you can sync your Google Calendar with the Noterro calendar. That way, your attestation reminders show up where you already manage your clinic schedule. Everything stays in one place and you’re less likely to miss a deadline.

Step 4: Submit Your Applications

Now that your documents are ready and your CAQH profile is live, you can start applying. Each insurance company has its own process. Some let you apply online. Others will send you paper forms. A few use third-party services.

Before you send anything in, double-check that all your info matches what’s in your CAQH. That includes your NPI, address, and license number. If something is off, it will slow things down or get rejected.

Make a list of each insurance company you apply to. Write down the date you sent it, who you sent it to, and what documents you included. This makes it easier to follow up later.

Keep a copy of everything you send. That way, if something gets lost, you don’t have to start from scratch.

Here’s something all chiropractors should know: How to Elevate Your Chiropractic Clinic’s Perceived Value For Free

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Step 5: Follow Up Regularly

Insurance companies don’t move fast. It can take 60 to 120 days for them to process your application. Sometimes longer. But that doesn’t mean you should just wait and hope for the best.

Follow up if you haven’t heard anything in 30 to 45 days. Be polite. Ask if they received your application and if they need anything else to move forward.

Here’s a simple message you can send:

Track who you talked to, when, and what they said. That way, you’re not chasing updates blindly. Don’t wait until something’s overdue. A quick follow-up can keep your application moving.

Also read: Top Challenges Chiropractors Face When Managing a Business

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Step 6: Stay Credentialed Over Time

Getting credentialed is one thing. Staying credentialed is another. Most insurance plans require re-credentialing every two or three years. If you miss the deadline, they can remove you from the panel.

Here’s how to stay ahead of it:

• Set a calendar reminder for every plan’s re-credentialing date.
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• Start updating your documents a few months before they’re due.
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• Keep your CAQH profile updated year-round.
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• Report any changes to your practice right away, like a new address, a license renewal, or a new provider joining your clinic.

Use your chiropractic practice management software to help you stay on track. If you stay organized, it’s just another admin task you can knock out without stress.

Avoid the Mistakes That Slow Everything Down

Even if the big steps are correct, tiny mistakes can still delay things. These are the ones that crop up most frequently. It takes a lot of time to fix them later.

Watch Your Expiry Dates

Expired documents are rejected. Even if your malpractice coverage or license expires just after you apply, they will not accept it. Check all the dates before you submit anything. Do the same with re-credentialing. If something is close to its expiration, renew it first.

Don't Send Everything at Once

You don’t need to apply to all insurance panels in one shot. Start with one or two. When those are in progress, move on to the next. It’s easier to keep track of your follow-ups, and there’s less risk of missing something.

Get Help if You're Stuck

If you don't have time or the process is taking too long, you don't need to do it all yourself. Credentialing services and billing firms can do it for you. It's an extra expense, but it can prevent lost revenue and headaches.

Make a Folder for Every Folder

If you’re running a multi-provider clinic, each chiropractor needs their own file. Keep their license, malpractice, NPI, and CAQH login together. It makes renewals faster and onboarding smoother.

Also read: 11 Security Steps to Onboard New Hires at Your Chiropractic Clinic 

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Conclusion

Credentialing is time-consuming, but it's worth it because it puts money in your pocket. It puts you in front of more patients and it gives your clinic a better position in your community.

You don't have to do it all at one time, but you must keep yourself organized. Take the steps, keep your information up to date, and don't hesitate to seek help if you need it.

Need an easy way to begin? Download our free credentialing checklist above.

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FAQs

What is the typical timeline for insurance credentialing

Credentialing usually takes between 60 to 120 days, depending on the insurer’s process and how complete your application is.

What is checked during a credentialing process?

Insurance companies verify several things: your active license, malpractice insurance, education (including chiropractic school completion), training history, board certifications if applicable, NPI number, and work experience. They also review any disciplinary actions, gaps in employment, or prior malpractice claims.

Can providers see patients before payer credentialing is done?

Technically, yes, but there are risks. You can provide care, but you can’t bill the insurer until you’re fully credentialed and contracted. If you see patients before that, you may need to hold claims or eat the cost. Some payers offer retroactive billing once credentialed, but not all. It’s safer to check each insurer’s policy before seeing those patients.

What are the 4 core criteria for credentialing and privileging?

The main things reviewed during credentialing are: (1) current and unrestricted professional license, (2) education and training background, (3) relevant work experience and clinical competency, and (4) active malpractice insurance with acceptable coverage limits. These are the foundations for getting approved to join a payer’s panel.

What does “credentialing” or “being credentialed” mean?

Credentialing is the process insurance companies use to verify that a healthcare provider meets their standards to deliver care and bill for services. It involves checking your qualifications, work history, and documentation. Once credentialed, you’re eligible to contract with the insurer and get reimbursed for patient visits under their plans.