The 10 Hardest Insurance Companies to Get Credentialed With (And How to Speed Each One Up)

In This Article

• Why Some Payers Are So Much Harder Than Others
• 1. Cigna Healthcare
• 2. Illinois Medicaid (HFS)
• 3. New York Medicaid (eMedNY)
• 4. Anthem BCBS in California, New York, and Large Markets
• 5. California Medi-Cal
• 6. Pennsylvania Medicaid (DHS)
• 7. Regional BCBS Plans With Paper-Only Portals
• 8. Workers Compensation Carriers and State Fund Programs
• 9. Medicaid MCOs in States With Five or More Plans
• 10. Dental Payers (Delta Dental Regional Plans)
• Summary Comparison Table
• What You Can Do Right Now

Key Takeaways

• Cigna Healthcare is the single most difficult national payer for credentialing, with committee review bottlenecks that stretch applications to 120 days or longer
• State Medicaid programs in Illinois, New York, California, and Pennsylvania each present unique obstacles that range from paper only submissions to separate MCO enrollment layers
• Some BCBS affiliates still require paper applications with no electronic submission option, creating delays that would not exist with a digital portal
• Workers compensation credentialing is often overlooked entirely because each state runs its own program with no standardized process
• Tracking every application with a dedicated follow up schedule (weekly at minimum) is the single most effective way to reduce credentialing timelines across all difficult payers
• Incomplete applications are the number one reason for credentialing delays at every payer on this list, making upfront document preparation the highest value activity you can do

Rachel Solis had been credentialing providers for eleven years when she made a mistake that cost her practice $214,000 in lost revenue. It was not a documentation error or a missed deadline. It was something much simpler: she assumed that Cigna Healthcare would process her new cardiologist's application in the same 45 to 60 day window she had grown accustomed to with Aetna and UnitedHealthcare.

Six weeks passed with no update. She called Cigna's provider services line and waited on hold for 38 minutes before learning that her application had been "received but not yet assigned to a credentialing analyst." At the eight week mark, she received a letter requesting three additional documents that had not been listed in the original application requirements. By the time Dr. Patel's enrollment was fully approved, 127 days had elapsed. During that entire period, every Cigna patient Dr. Patel saw was either billed under a different provider (creating compliance risk) or written off entirely.

Rachel's experience is not unusual. In fact, it is exactly what happens when credentialing professionals treat all payers the same. The reality is that certain insurance companies, state Medicaid programs, and specialty payers present dramatically more difficult enrollment processes than others. Some require obscure forms. Others route applications through multi-layered committee reviews. A few still operate almost entirely on paper in an era when most of healthcare has gone digital.

This guide ranks the ten hardest payers to get credentialed with, explains exactly why each one is difficult, and provides specific strategies for speeding up the process with each. If you are responsible for payer enrollment at your practice or organization, this is the reference you will return to every time you start a new application with a challenging payer.

For a broader look at credentialing timelines across all payer types, our timeline guide covers the full landscape.

Why Some Payers Are So Much Harder Than Others

Before getting into the individual rankings, it helps to understand the structural reasons why certain payers take so much longer than others.

Committee review schedules. Many payers require a formal credentialing committee to vote on each application. These committees may only meet once per month, which means an application that just missed the cutoff date sits idle for an additional 30 days before anyone even looks at it.

Documentation standards that exceed NCQA requirements. The National Committee for Quality Assurance (NCQA) sets baseline credentialing standards that most payers follow. However, some payers layer on additional requirements: extra attestation forms, specific formatting for CVs, notarized copies of documents that other payers accept as scanned PDFs. Each additional requirement adds potential delay.

Portal limitations. Some payers have fully digital enrollment portals where you can submit, track, and receive updates on applications in real time. Others have portals that are little more than a PDF download page. A handful still require mailed paper applications. The less visibility you have into where your application stands, the harder it becomes to intervene when something stalls.

Internal processing capacity. Large state Medicaid programs often process tens of thousands of provider applications per year with staff levels that have not kept pace with demand. The result is predictable: backlogs that can stretch applications from the expected 60 day window to 120 days or beyond.

Network adequacy decisions. Some payers, particularly large commercial carriers in saturated metro markets, are not just verifying your credentials. They are also deciding whether they need another provider in your specialty and location. A panel that is considered "full" can mean your application is deprioritized or denied entirely, regardless of how clean your documentation is.

Understanding these root causes helps you adjust your approach for each payer on this list. A strategy that works for a slow state Medicaid agency (patience plus persistent follow up) will not work for a payer with closed panels (where you need to demonstrate network need).

1. Cigna Healthcare

Average Timeline: 60 to 120 days Difficulty Rating: Highest among national commercial payers

Why Cigna Is So Hard

Cigna Healthcare consistently ranks as the most difficult national commercial payer for provider credentialing, and the reasons go beyond simple processing speed.

First, Cigna uses a multi-stage committee review process. Unlike payers that delegate initial credentialing decisions to individual analysts, Cigna routes most new applications through a formal credentialing committee. These committees operate on fixed meeting schedules, and if your application arrives just after a committee has convened, you may wait three to four weeks before it is even reviewed for the first time. That waiting period is in addition to the intake and verification stages that precede it.

Second, Cigna is known for sending documentation requests well into the review process that other payers would have flagged at intake. Credentialing coordinators frequently report receiving requests for additional malpractice history details, hospital privilege letters, or updated CAQH attestations at the 45 to 60 day mark. Each request resets the clock on that portion of the review.

Third, Cigna's provider services phone lines are among the most difficult to reach. Hold times of 30 minutes or more are common, and the representatives who answer often cannot provide specific status details beyond "your application is in review." This lack of transparency makes proactive follow up both essential and frustrating.

Most Common Denial Reason

Incomplete or outdated CAQH ProView profile. Cigna pulls heavily from CAQH, and if any section of your profile is blank, expired, or inconsistent with the information on your direct application, Cigna will flag the discrepancy. This is the single most preventable cause of Cigna credentialing delays.

Three Strategies to Speed Up Cigna Credentialing

Complete your CAQH profile before submitting to Cigna. Every field, every attestation, every document upload. Re-attest within 30 days of your Cigna submission so the data is as current as possible. Verify that your malpractice coverage dates, license numbers, and practice addresses match exactly between CAQH and your Cigna application. For a full walkthrough, see our Cigna credentialing and enrollment guide.

Ask for the committee meeting schedule. When you submit your application, call Cigna's credentialing department and ask when the next committee review date is. Time your submission so your application has a full review cycle to clear intake and verification before the next committee meeting. If you submit two days after a committee meets, you have just added a month of dead time.

Escalate through your Cigna network representative, not provider services. If you have a dedicated Cigna network representative for your region, use that relationship. Network reps can escalate stalled applications internally in ways that the general provider services line cannot. If you do not have a network rep, ask your state medical association for the Cigna provider relations contact in your area.

2. Illinois Medicaid (HFS)

Average Timeline: 90 to 180+ days Difficulty Rating: Highest among state Medicaid programs

Why Illinois Medicaid Is So Hard

The Illinois Department of Healthcare and Family Services (HFS) administers one of the most backlogged Medicaid programs in the country. Processing delays of six months are not exceptional. They are routine.

The core problem is structural. Illinois HFS still relies heavily on paper based application processing. While there is an electronic enrollment option through the Illinois Medicaid Provider Enrollment portal, many application types and updates still require mailed documents. Paper applications introduce delays at every stage: mail transit time, manual data entry by state staff, physical routing of files between departments, and the risk of documents being lost or misfiled.

Adding to the complexity, Illinois requires providers to enroll separately with each Medicaid Managed Care Organization (MCO) that operates in the state. Simply enrolling with HFS fee for service does not give you access to the managed care population, which represents the majority of Illinois Medicaid beneficiaries. Each MCO has its own application, its own timeline, and its own credentialing requirements. A provider who needs to participate in all major Illinois Medicaid MCOs could be managing four to six separate enrollment applications simultaneously.

Communication with HFS is also notoriously difficult. The provider enrollment hotline is often overwhelmed, and email inquiries may go unanswered for weeks.

Most Common Denial Reason

Application returned as "incomplete" due to missing or incorrectly formatted supporting documents. Illinois HFS has specific formatting requirements for certain attachments (including the size and format of uploaded images for ID verification), and applications that do not meet these specifications are returned without detailed instructions on how to correct the issue.

Three Strategies to Speed Up Illinois Medicaid Credentialing

Use the electronic portal whenever possible and send backup paper copies. Submit electronically first, then mail a complete paper duplicate with a cover letter referencing your electronic submission date and confirmation number. This creates a backup in case the electronic submission encounters processing issues, and it gives you a documented submission date you can reference in follow up calls.

Start MCO enrollment simultaneously with HFS enrollment. Do not wait for HFS approval before beginning your MCO applications. Most Illinois MCOs will accept applications while your HFS enrollment is pending, and some will even approve you conditionally. Starting all applications at once can cut months off your total enrollment timeline. For state specific Medicaid strategies, see our Medicaid credentialing by state guide.

Document every interaction with a date, time, representative name, and reference number. Illinois HFS representatives sometimes provide conflicting information on different calls. Keeping a detailed log protects you when you need to escalate, and it gives you evidence if an application is lost and you need to prove your original submission date.

3. New York Medicaid (eMedNY)

Average Timeline: 90 to 150 days Difficulty Rating: Very high, compounded by MCO complexity

Why New York Medicaid Is So Hard

New York's Medicaid program, administered through the eMedNY system, is one of the largest in the country by enrollment. That scale alone creates processing challenges. But what makes New York particularly difficult is the interaction between fee for service Medicaid enrollment and the state's extensive Medicaid Managed Care landscape.

New York has transitioned the vast majority of its Medicaid population into managed care. Depending on the region, providers may need to enroll with anywhere from five to twelve separate Medicaid Managed Care plans to serve the full Medicaid population in their area. Each plan has its own credentialing process, its own provider relations team, and its own timeline. Some accept CAQH data directly. Others require plan specific applications.

The eMedNY enrollment system itself, while electronic, is dated and unintuitive. Error messages are often cryptic, and the system does not always provide clear confirmation that an application was received successfully. Providers who are accustomed to modern enrollment portals frequently find eMedNY frustrating to work with.

New York also requires specific documentation for out of state providers seeking to participate in NY Medicaid, including verification of licenses in the provider's home state and sometimes additional background checks.

Most Common Denial Reason

Failure to complete Medicaid Managed Care enrollment separately from fee for service enrollment. Providers who enroll only in eMedNY and assume they can bill managed care plans are surprised to learn their claims are denied because managed care enrollment is an entirely separate process.

Three Strategies to Speed Up New York Medicaid Credentialing

Map your MCO enrollment requirements before you start. Identify which Medicaid MCOs operate in your county and which ones your patient population is enrolled in. Prioritize the two or three MCOs with the largest market share in your area and start those applications first. You can add smaller plans later without losing significant revenue.

Verify your eMedNY submission was received by calling the enrollment hotline within 48 hours of submitting. Do not rely solely on the system's confirmation screen. Request a reference number and the name of the representative who confirms receipt. This simple step prevents the situation where your application sits in a queue for weeks only to discover it was never properly received.

Use CAQH as your central data source and authorize every NY MCO to access it. Log into CAQH ProView and add every NY Medicaid MCO to your authorized health plan list. This allows plans to pull your credentialing data directly, reducing the back and forth of document requests and shortening their review cycle.

4. Anthem BCBS in California, New York, and Large Markets

Average Timeline: 90 to 120+ days Difficulty Rating: Very high in saturated metro markets

Why Anthem BCBS in Large Markets Is So Hard

Anthem Blue Cross Blue Shield operates as a dominant carrier in several large states, and in those markets, credentialing with Anthem is significantly harder than with other BCBS affiliates. The primary reason is not administrative inefficiency. It is network saturation.

In metro areas like Los Angeles, New York City, and major markets in Georgia, Indiana, and Virginia, Anthem frequently closes its provider panels to new applicants in specialties where it determines the network is already adequate. When panels are closed, your application may be accepted, reviewed, and then denied not because of any deficiency in your credentials but because Anthem has decided it does not need another provider in your specialty and geography.

Even when panels are open, Anthem's credentialing process in large markets involves an additional layer of network adequacy review that other BCBS plans skip. Your application is not just being verified against credentialing standards. It is also being evaluated against Anthem's internal network adequacy models, which consider provider to member ratios, geographic distribution, and specialty coverage. This additional review can add 30 to 45 days to the standard processing timeline.

Anthem also operates different enrollment systems in different states, which means the process you learned for Anthem in Virginia may not apply at all to Anthem in California. For a state by state breakdown of BCBS credentialing, see our BCBS credentialing guide.

Most Common Denial Reason

Panel closure in the provider's specialty and geographic area. This denial is particularly frustrating because there is often no way to know whether the panel is open before you submit your application and wait 60 to 90 days for a decision.

Three Strategies to Speed Up Anthem BCBS Credentialing

Call Anthem's provider recruitment line before submitting your application and ask specifically whether panels are open in your specialty and zip code. Get the name and direct number of the representative who confirms panel status. If panels are closed, ask to be placed on a wait list and ask how frequently panel status is reviewed. This single phone call can save you three months of waiting on an application that was never going to be approved.

Submit a letter of network need with your application. If you are opening a practice in an underserved area, joining a group that is losing a provider, or offering a subspecialty that the current network lacks, document this in a formal letter attached to your application. Anthem's network adequacy team reviews these letters, and a compelling case for network need can result in panel exceptions.

Apply through the group practice rather than as an individual. If you are joining an established group that already participates with Anthem, your application may receive expedited handling because Anthem has an existing contractual relationship with the group. Group adds are often processed faster than new individual applications, particularly in tight markets.

5. California Medi-Cal

Average Timeline: 90 to 120 days Difficulty Rating: High, driven by state agency processing delays

Why California Medi-Cal Is So Hard

California's Medicaid program, known as Medi-Cal, is the largest state Medicaid program in the nation by enrollment. The Department of Health Care Services (DHCS) processes provider enrollment applications for a state with over 15 million Medi-Cal beneficiaries, and the volume creates predictable bottlenecks.

One of the most common issues with Medi-Cal enrollment is provider type confusion. Medi-Cal uses a provider type and specialty code system that does not always align neatly with federal taxonomy codes or the way providers describe their own practice. Selecting the wrong provider type on your application can result in weeks of delay while the application is rerouted to the correct processing unit, or worse, a denial that requires you to start the application over entirely.

DHCS has made progress in moving enrollment online through its Provider Enrollment Division portal, but the system still has gaps. Certain provider types must submit paper applications. Status updates through the portal are delayed, sometimes showing application stages that are weeks behind the actual processing status.

California's sheer geographic size also means that DHCS regional offices operate somewhat independently, and processing times can vary significantly depending on which office handles your application.

Most Common Denial Reason

Incorrect provider type or specialty code selection on the enrollment application. Because Medi-Cal's provider type categories do not always match standard industry terminology, providers frequently select the wrong category, which triggers a rejection or rerouting that adds weeks to the timeline.

Three Strategies to Speed Up Medi-Cal Credentialing

Confirm your exact Medi-Cal provider type and specialty code before submitting. Call the DHCS Provider Enrollment Division and describe your practice specialty. Ask them to confirm which provider type code you should use on your application. Do not rely on the descriptions in the application form alone, as they can be misleading for providers whose specialties cross multiple categories.

Submit your Medi-Cal application at the same time as your Medicare enrollment. Medi-Cal requires an active NPI and, for most provider types, an active Medicare enrollment or a Medicare opt out affidavit. If you submit your Medi-Cal application before your Medicare enrollment is complete, DHCS may hold your application until Medicare processing is finished. Submitting both simultaneously ensures neither one is waiting on the other.

Follow up every two weeks with a documented phone call. DHCS applications can stall without notification. Calling every two weeks and requesting a status update (with the representative's name and any reference numbers) keeps your application visible and ensures you catch any issues before they add months to your timeline.

6. Pennsylvania Medicaid (DHS)

Average Timeline: 75 to 120 days Difficulty Rating: High, especially for providers new to the state

Why Pennsylvania Medicaid Is So Hard

The Pennsylvania Department of Human Services (DHS) runs a Medicaid program that combines a complex application process with the added requirement of separate MCO enrollment. Like Illinois and New York, Pennsylvania has moved most of its Medicaid population into managed care, which means fee for service enrollment with DHS is only the beginning.

Pennsylvania's enrollment process is heavily paper based for certain provider types. While PROMISe (Pennsylvania's Medicaid management system) does offer some electronic functionality, many enrollment actions still require paper forms, wet ink signatures, and mailed supporting documents. The transition between electronic and paper steps within a single application creates confusion and opportunities for documents to be separated or lost in processing.

Additionally, Pennsylvania requires specific documentation that other states do not, including a Pennsylvania criminal background check (separate from the federal background check most payers require) and, for certain provider types, a Child Abuse History Certification. These state specific requirements catch out of state providers off guard and add processing time when they are not included with the initial submission.

Most Common Denial Reason

Missing Pennsylvania specific background check documentation. The state criminal background check and Child Abuse History Certification are required in addition to federal background screening, and applications submitted without them are returned as incomplete.

Three Strategies to Speed Up Pennsylvania Medicaid Credentialing

Order your Pennsylvania criminal background check and Child Abuse History Certification before you start your DHS application. These documents can take two to four weeks to arrive, and submitting your DHS application without them guarantees a return for incompleteness. Order them the moment you decide to enroll in PA Medicaid, even before you have the rest of your application materials ready.

Begin MCO enrollment as soon as you receive your PROMISe provider ID. Pennsylvania MCOs will generally accept applications once you have a PROMISe ID, even if your full DHS enrollment is still being finalized. Starting MCO applications early means you are moving through multiple enrollment pipelines in parallel rather than sequentially.

Maintain a separate tracking spreadsheet for each PA MCO application. Pennsylvania has multiple MCOs operating in different regions, and each one has different submission methods, different follow up contacts, and different processing timelines. Tracking them all in a single document prevents applications from falling through the cracks.

7. Regional BCBS Plans With Paper-Only Portals

Average Timeline: 90 to 120 days Difficulty Rating: High due to lack of electronic submission and tracking

Why These BCBS Plans Are So Hard

Blue Cross Blue Shield is not a single company. It is an association of 34 independent, locally operated companies. While many BCBS affiliates have invested in modern electronic credentialing portals, several smaller and regional plans still operate with paper only or minimal electronic capabilities.

These plans typically require providers to download PDF application forms, complete them by hand or in a PDF editor, print them, sign them with wet ink, attach physical copies of supporting documents, and mail the entire package to the plan's credentialing department. There is no online tracking. There is no electronic confirmation of receipt. Follow up requires phone calls to a credentialing department that may have limited staffing.

The lack of electronic submission creates delays at multiple points. Mail transit adds days in each direction. Manual data entry by plan staff introduces errors that require corrections. Physical routing of paper files between departments creates opportunities for documents to be misfiled. And without an online portal, there is no way for you to check the status of your application without calling and waiting on hold.

These plans are also less likely to pull data from CAQH ProView, meaning you cannot rely on your CAQH profile to populate any portion of the application. Everything must be completed manually.

Most Common Denial Reason

Incomplete application returned due to missing signatures, missing pages, or illegible handwriting on paper forms. Physical applications are prone to errors that electronic submissions prevent automatically.

Three Strategies to Speed Up Paper-Only BCBS Credentialing

Use a PDF editor (not handwriting) for every field, then print for wet ink signature. Typed applications are processed faster because they eliminate legibility issues. Complete the entire application digitally, print it, sign and date only the fields that require original signatures, and then photocopy the completed application for your records before mailing.

Send applications via certified mail or a tracked shipping service with delivery confirmation. This gives you a documented receipt date that you can reference in follow up calls. If the plan claims they never received your application, you have proof of delivery. Many credentialing coordinators who work with paper heavy plans use FedEx or UPS with signature required delivery for exactly this reason.

Call to confirm receipt within five business days of delivery and request a direct phone number or email for the assigned credentialing analyst. Getting the name and contact information of the specific person handling your file transforms your follow up from a blind call to a general phone line into a targeted check in with the person who can actually move your application forward. This single step can shave weeks off the process.

8. Workers Compensation Carriers and State Fund Programs

Average Timeline: 60 to 120 days Difficulty Rating: High due to fragmentation and lack of standardization

Why Workers Comp Credentialing Is So Hard

Workers compensation credentialing is fundamentally different from medical insurance credentialing, and that difference is what makes it so difficult. There is no national system. There is no standardized application. There is no equivalent of CAQH for workers comp. Each state runs its own workers compensation program with its own rules, its own forms, and its own processing timelines.

In states with competitive workers compensation markets, providers may need to credential with the state fund (if one exists), multiple private carriers, and sometimes a separate state industrial commission or workers compensation board. The requirements for each can vary dramatically. One carrier may require an occupational medicine certification. Another may require proof of specific training in impairment ratings. A third may simply need your standard credentialing documents plus a workers compensation specific fee schedule acknowledgment.

State fund programs, which are government run workers comp insurance options available in about 20 states, often have the longest processing times. These programs are run by state agencies with the same staffing and processing limitations that affect state Medicaid programs. Applications to state fund programs in Ohio, Washington, and New York can take 90 to 120 days during peak periods.

Adding to the complexity, workers compensation credentialing is often handled by a completely different department within a practice than medical insurance credentialing. The credentialing coordinator who manages your commercial payer enrollments may have no experience with workers comp requirements, leading to avoidable errors and delays.

Most Common Denial Reason

Missing state specific workers compensation documentation, such as occupational medicine certifications, state workers compensation board registration, or fee schedule acknowledgment forms that are unique to the workers comp system.

Three Strategies to Speed Up Workers Comp Credentialing

Contact your state's workers compensation board or industrial commission first. Before approaching any carrier, find out what state level registration or authorization is required. Some states require providers to register with the state workers compensation board before they can bill any workers comp carrier. Completing this step first prevents carriers from rejecting your application for missing state authorization.

Identify the three to five largest workers comp carriers in your state and prioritize those applications. Workers compensation market share is often concentrated among a small number of carriers. In many states, the state fund plus two or three large private carriers handle 70 to 80 percent of all workers comp claims. Focus your initial enrollment efforts on these high volume carriers rather than trying to credential with every carrier at once.

Create a workers comp specific credentialing checklist that is separate from your medical insurance checklist. Workers comp applications require different documents (occupational medicine certifications, fee schedule agreements, state board registrations) than medical insurance applications. Maintaining a separate checklist ensures you gather all required documents before starting the application and prevents the confusion that comes from trying to use your medical insurance credentialing workflow for a fundamentally different process.

9. Medicaid MCOs in States With Five or More Plans

Average Timeline: 75 to 120 days per MCO (cumulative burden across multiple plans) Difficulty Rating: High due to volume and coordination challenges

Why Multi-MCO Medicaid States Are So Hard

The difficulty here is not that any individual Medicaid MCO has an unusually complex credentialing process. Most MCOs follow standard credentialing workflows and many accept CAQH data. The challenge is cumulative.

In states like Florida, Texas, New York, Ohio, and Illinois, providers who want to serve the full Medicaid population must enroll with five, eight, or even twelve separate MCOs. Each MCO has its own application (even if they all pull from CAQH, they each require separate authorization and often supplemental forms). Each has its own credentialing timeline. Each has its own follow up process. And each can request additional documentation independently.

Managing five to twelve simultaneous enrollment applications, each at a different stage of processing, each with its own deadlines and contact points, is a full time coordination challenge. It is not unusual for a credentialing coordinator to spend 20 to 30 hours per provider just managing Medicaid MCO applications in a multi-plan state. And because each MCO processes independently, you may be fully credentialed with three MCOs while still waiting 90 days for the other four.

The revenue impact is significant. A provider who is credentialed with only half of the MCOs in their market is turning away or eating the cost of patients enrolled in the plans where enrollment is still pending. For detailed strategies on handling enrollment denials and delays, see our provider enrollment denial and appeal guide.

Most Common Denial Reason

Failure to authorize the specific MCO to access the provider's CAQH profile. Each MCO must be individually authorized in CAQH ProView, and providers who authorize only the state Medicaid agency (but not the individual MCOs) find that the MCOs cannot retrieve their credentialing data.

Three Strategies to Speed Up Multi-MCO Medicaid Enrollment

Authorize every MCO in your state to access your CAQH profile before you submit a single application. Log into CAQH ProView, go to the "Manage Health Plans" section, and add every Medicaid MCO in your state to your authorized list. This preemptive step eliminates the most common delay point in MCO credentialing. Even if you are not planning to apply to a specific MCO immediately, authorizing them now costs nothing and saves time later.

Submit all MCO applications on the same day. Rather than staggering applications over weeks, submit them all at once. This starts all clocks running simultaneously and means you reach full enrollment across all plans at roughly the same time, rather than having a months long gap between your first and last MCO approval.

Assign a tracking system with weekly follow up dates for each MCO. Whether you use a spreadsheet, a project management tool, or a dedicated credentialing platform, each MCO application needs its own row with columns for submission date, confirmation number, current status, next follow up date, and contact information for the credentialing analyst. Review this tracker weekly and make follow up calls to any MCO that has not provided an update in the past two weeks. The practices that reduce their total MCO enrollment time most effectively are the ones that treat each application as its own mini project with dedicated attention. Our timeline estimator tool can help you project realistic completion dates for multi-payer enrollment.

10. Dental Payers (Delta Dental Regional Plans)

Average Timeline: 60 to 90 days Difficulty Rating: Moderate to high, primarily due to separation from medical credentialing

Why Dental Payer Credentialing Is So Hard

Delta Dental, like BCBS, is not a single company. It is a network of independent, state based dental insurance companies that operate under the Delta Dental name. Each Delta Dental affiliate has its own enrollment process, its own credentialing requirements, and its own timeline.

The fundamental challenge with dental payer credentialing is that it operates on an entirely separate track from medical credentialing. Dental providers cannot use their medical CAQH profile for dental credentialing (some Delta Dental plans use CAQH, but many do not). The credentialing verification databases are different. The provider taxonomy codes are different. The application forms are different.

For practices that offer both medical and dental services (which is increasingly common in settings like community health centers, pediatric practices, and large multi-specialty groups), this separation means maintaining two completely parallel credentialing workflows with different systems, different contacts, and different follow up schedules.

Delta Dental plans in some states also have limited credentialing staff compared to their medical insurance counterparts. Dental credentialing departments are often smaller, which means phone hold times can be longer and email response times slower.

Some regional Delta Dental plans also restrict their networks more aggressively than medical payers, closing panels in areas where they determine the network is adequate. This panel closure issue is similar to what providers experience with Anthem BCBS in large markets, but it is less well known in the dental space because fewer resources cover dental credentialing compared to medical credentialing.

Most Common Denial Reason

Submitting a medical credentialing application or medical CAQH data instead of completing the dental specific enrollment process. Dental credentialing is a separate system, and medical credentialing documents are not accepted as substitutes for dental specific forms.

Three Strategies to Speed Up Dental Payer Credentialing

Identify which Delta Dental affiliate operates in your state and contact them directly for application materials. Do not use the national Delta Dental website to find enrollment forms, as it may not direct you to the correct state affiliate. Search for "[your state] Delta Dental provider enrollment" and go directly to the state affiliate's website. Each affiliate's requirements are different, and starting with the wrong forms wastes weeks.

Separate your dental credentialing workflow entirely from your medical credentialing workflow. Use different tracking spreadsheets, different follow up schedules, and ideally assign dental credentialing to a staff member who can give it dedicated attention rather than treating it as an afterthought to medical credentialing. Practices that treat dental enrollment as an add on to medical enrollment consistently experience longer delays because dental applications get deprioritized.

Ask whether your Delta Dental affiliate accepts CAQH for dental credentialing. Some Delta Dental affiliates have begun using CAQH ProView for dental provider credentialing, while others maintain their own separate credentialing systems. If your affiliate accepts CAQH, ensuring your dental specific information is current in CAQH can significantly reduce processing time. If they do not accept CAQH, you will need to complete their proprietary application, so finding this out early prevents wasted effort populating CAQH with dental data that will never be used.

Summary Comparison Table

What You Can Do Right Now

The payers on this list are hard for structural reasons that you cannot change. State agencies will always be understaffed. Committees will always meet on fixed schedules. Paper processes will always be slower than electronic ones. What you can change is how you prepare for and manage these difficult enrollments.

Three principles apply across every payer on this list:

Prepare your documents before you start any application. The number one cause of delays across all ten payers is incomplete applications. Before you submit to any payer, verify that your CAQH profile is fully attested within the last 30 days, all licenses are current, malpractice coverage dates are accurate, and you have gathered every state or payer specific document the application requires. Thirty minutes of preparation can save 30 days of processing delays.

Follow up on a fixed schedule and document every interaction. Set a recurring calendar reminder to check on each pending application. For most payers, every two weeks is appropriate. For the more difficult payers on this list (Cigna, Illinois Medicaid, Anthem BCBS in large markets), weekly follow up is justified. Record the date, time, representative name, and what you were told on every call. This documentation is invaluable when applications stall or when different representatives give conflicting information.

Start all applications simultaneously rather than sequentially. Whether you are enrolling with multiple MCOs in a single state or credentialing with several commercial payers at once, submit all applications as close together as possible. Sequential enrollment, where you wait for one approval before starting the next application, can add months to your total enrollment timeline.

If you are beginning the credentialing process and want to build a realistic timeline for your specific payer mix, our payer enrollment service can help you identify which payers in your market will require the most lead time and develop a submission strategy accordingly. For more strategies on reducing enrollment timelines across all payer types, see our guide on how to speed up provider enrollment with insurance companies.

The practices that get providers credentialed fastest are not the ones that work with easier payers. They are the ones that recognize which payers are going to be difficult and adjust their preparation, submission timing, and follow up intensity accordingly. Every payer on this list can be managed successfully. It just takes knowing what you are up against before you start.