How long can a payer take to credential you?

Ark. Code Ann. § 23-99-411 requires a credentialing decision within "Sixty (60) calendar days" of a completed application for physicians and "One hundred eighty (180) calendar days" for "any other provider," with written acknowledgment in 10 days; if no incompleteness notice goes out within 15 days "the application shall be deemed complete." Teeth apply to physicians only: "a fine of one thousand dollars ($1,000) per day shall be imposed for each day exceeding the sixty (60) days."

Ark. Code Ann. § 23-99-411 (FindLaw republication) · checked Jul 2026 · everything else about Arkansas

Arizona SB 1291 (Laws 2025, Ch. 97) mandates a 60-calendar-day credentialing decision from complete application, a 7-day acknowledgment of receipt, tolling capped at three rounds, and retro payment back to the complete-application date. Uniquely, it also puts a statutory deadline on the claims-system LOAD step: the insurer must load the applicant into its billing system within 130 calendar days. The statute exists because contracted-but-not-loaded is a distinct, common failure point.

AZ SB 1291 chaptered law via kb/states/az.md · checked Jul 2026 · everything else about Arizona

Read the dates carefully here, because California has three of them and only one bites today. AB 1041 added Health & Safety Code § 1374.198, under which a plan or its delegate "shall make a determination regarding the credentials of a health care provider within 90 days after receiving a completed provider credentialing application, including all required third-party verifications," with receipt acknowledged in 10 business days. Miss it and "the applicant's credentials shall be provisionally approved for 120 days," unless the applicant is under licensing discipline, carries an adverse action or malpractice payment report in the National Practitioner Data Bank, or has not been credentialed by that plan in the past five years. The catch is the phase-in: the section applies "within one year of the operative date of this section," and the operative date is January 1, 2026, so the 90-day duty is enforceable from January 1, 2027. Until then the only live clock is the 60-day behavioral health rule. Two further limits: the 90 days covers credentialing and "does not include contracting completion," and the section does not reach Medi-Cal contracts with the Department of Health Care Services. Insurers regulated by the Department of Insurance rather than DMHC sit under the mirror provision at Insurance Code § 10144.565. Separately, from January 1, 2028, full service plans "shall subscribe to and use the most recent version of the Council for Affordable Quality Healthcare (CAQH) credentialing form," and may only ask for information that clarifies or confirms what the CAQH form already carries.

California Legislative Information, AB 1041 (Chapter 630, 2025) · checked Jul 2026 · everything else about California

Colorado gives carriers 60 days and counts them in calendar days, not business days. A carrier "shall conclude the process of credentialing an applicant within sixty calendar days after the carrier receives the applicant's completed application," and must then give written or electronic notice of the outcome "within ten calendar days after the conclusion of the credentialing process." Read the scope before relying on it: the section applies to physicians, defined as those licensed under Article 240 of Title 12, so it does not carry over to behavioral health or allied clinicians.

Colorado General Assembly, Senate Bill 21-126 as enacted (C.R.S. 10-16-705.7) · checked Jul 2026 · everything else about Colorado

None found. Delaware's managed-care law, 18 Del. C. ch. 64, Regulation of Managed Care Organizations (§§ 6401-6420), contains no credentialing-deadline section; the full text was checked with zero "credential" occurrences, and Delaware is also absent from cross-state prompt-credentialing tables.

18 Del. C. ch. 64 (delcode.delaware.gov, verified negative) · checked Jul 2026 · everything else about Delaware

Iowa Code § 514F.6 requires a health insurer to respond to a physician, advanced registered nurse practitioner, or physician assistant's request for credentialing within fifty-six calendar days from the date of the request, and the insurance commissioner must adopt rules for the retrospective payment of clean claims for covered services provided during the credentialing period once the provider is credentialed. Written denials are required. Scope trap: the statute names only physicians, ARNPs, and PAs. Master's-level behavioral health clinicians are not covered.

Iowa Code 2026 § 514F.6 (legis.iowa.gov) · checked Jul 2026 · everything else about Iowa

IC 27-8-11-7 (amended 2023) is one of the strongest start-billing-sooner levers in any state: if an insurer fails to issue a credentialing determination within 15 BUSINESS DAYS of a clean completed application (the DOI-prescribed CAQH form), it must provisionally credential the provider, and once fully credentialed with an executed agreement, reimbursement is paid retroactive to the provisional date. Deficiency notices on unclean applications are due in 5 business days. Invoke the clock on every clean Indiana commercial application; the only downside risk is non-reimbursement of the provisional period if credentialing is ultimately denied.

IC 27-8-11-7 full text via kb/states/in.md · checked Jul 2026 · everything else about Indiana

Louisiana caps the clock at 90 days, but the clock starts late. An issuer "shall complete a credentialing process within ninety days from the date on which the issuer has received all the information needed for credentialing, including the health care provider's correctly completed application and attestations and all verifications or verification supporting statements required by the issuer." The 90 days run from a complete file, not from the day you submit, so an application returned twice for corrections can sit well past 90 days without the payer breaching the statute.

Louisiana State Legislature, R.S. 22:1009 · checked Jul 2026 · everything else about Louisiana

Maryland's prompt-credentialing statute (Insurance § 15-112) binds commercial carriers only: within 30 days of receiving a completed application the carrier must send written notice of intent to continue or a rejection, and if it continues it has 120 days from that notice to accept or reject the provider. Critically, § 15-112 does NOT reach the Medicaid HealthChoice MCOs or the BH ASO (Carelon). Medicaid credentialing is governed by the HealthChoice MCO Agreement, COMAR 10.67 and 42 CFR 455 instead. Do not invoke the 30/120-day clock against an MCO or the ASO.

Md. Code, Insurance § 15-112 (official text) via kb/states/md.md · checked Jul 2026 · everything else about Maryland

Maine gives carriers 60 days, which is among the tighter windows in the country. "A carrier shall make credentialing decisions, including those granting or denying credentials, within 60 days of receipt of a completed credentialing application from a provider." As in most states the clock keys to a completed application, defined here as the uniform credentialing application plus the attachments the carrier required at submission plus every correction the carrier asked for.

Maine Legislature, 24-A M.R.S. § 4303 · checked Jul 2026 · everything else about Maine

Minn. Stat. 62Q.097 requires a health plan company to make a determination on a clean credentialing application within 45 days of receipt (30 additional days only for a substantive quality or safety concern), and to flag deficiencies on non-clean applications within 3 business days. Use it to hold Minnesota health plans, including Medicaid MCOs as health plan companies, to the 45-day clock on complete files.

Minn. Stat. 62Q.097 (official Revisor text) via kb/states/mn.md · checked Jul 2026 · everything else about Minnesota

RSMo § 376.1578 requires commercial health carriers to acknowledge receipt within 2 working days and decide a completed credentialing application within 60 days (four narrow exceptions). The stronger lever is § 376.1578.4: if approved, the carrier must pay for covered services performed DURING the credentialing period when rendered on behalf of an entity already contracted with that carrier. So invoke it for every provider joining an already-contracted Missouri group. It also waives credentialing for locum coverage of an absent practitioner. The statute binds commercial carriers; its reach to Medicaid MCOs is not established.

RSMo § 376.1578 (official Revisor) via kb/states/mo.md · checked Jul 2026 · everything else about Missouri

None. Miss. Code Ann. § 83-41-409, the managed-care credentialing statute, contains no decision clock: it only obliges plans to file a summary of the plan credentialing criteria, process and policies, disclose whether practice profiles are used, and provide a denial-review process. No deadline, no deemed-approval, no retroactive pay.

Miss. Code Ann. § 83-41-409 (FindLaw republication, current through 2025-01-01) · checked Jul 2026 · everything else about Mississippi

None. Montana law sets no deadline for a health insurer to complete credentialing. Mont. Code Ann. § 33-36-203 requires carriers to adopt provider-selection standards but imposes no timeline, and ARM 6.6.8816 requires credentials review before contracting plus reverification at least every 3 years, also with no decision deadline. Unlike some states, no Montana statute forces an insurer to act within a set number of days.

Montana Code Annotated (mca.legmt.gov) · checked Jul 2026 · everything else about Montana

None. No North Dakota prompt-credentialing statute was found: the NDCC Title 26.1 (Insurance) chapter index contains no credentialing chapter. Unlike some states, no ND law forces an insurer to complete credentialing within a set number of days.

North Dakota Century Code Title 26.1 chapter index (verified negative) · checked Jul 2026 · everything else about North Dakota

None. Neb. Rev. Stat. §44-7006 (Credentialing Verification Act) sets carrier credentialing-policy and committee requirements but contains no decision deadline and no retro-pay, and §44-4109.01 gives providers an annual right to apply to a PPO with no clock. No Nebraska statute forces a credentialing decision within a set number of days.

Neb. Rev. Stat. § 44-7006 (Credentialing Verification Act) · checked Jul 2026 · everything else about Nebraska

RSA 420-J:4(I)(h) requires a health carrier to "Act upon and finalize the credentialing process within 30 calendar days of receipt of a clean and complete application for primary care physicians and mental health providers and within 45 days of receipt of a clean and complete application for specialists," with incomplete-application notice due "not later than 15 business days." The statute was amended effective Jan. 1, 2026 and the 30/45-day clause survives. A 30-day clock covering mental-health providers by name is rare; hold NH plans to it.

NH RSA 420-J:4, Credentialing Verification Procedures · checked Jul 2026 · everything else about New Hampshire

45 calendar days. Within 45 calendar days of receiving a credentialing request, a health carrier must assess and verify the provider's qualifications and determine whether to approve or deny the application (13.10.28.11(C) NMAC, effective 01/01/2017 and never amended). The carrier must acknowledge receipt by certified mail within 10 days and send deficiency requests within 10 business days.

13.10.28 NMAC, Provider Payment and Provider Credentialing Requirements (OSI) · checked Jul 2026 · everything else about New Mexico

NY Public Health Law § 4406-d gives managed-care plans 60 days from a completed application to say whether the professional is credentialed (21 days after late third-party documentation arrives). The teeth: a newly licensed professional, or one who recently relocated to NY, joining a fully in-network group who is neither approved nor declined within 60 days is DEEMED provisionally credentialed and may participate in-network from day 61, and the plan may not deny their claims after appeal solely as untimely filed. Capture the completed-application receipt date, it starts both clocks. This binds Article 44 managed-care plans, not eMedNY/Medicaid FFS enrollment.

NY PHL § 4406-d (official statute text) via kb/states/ny.md · checked Jul 2026 · everything else about New York

Ohio is one of the few states that puts a price on a missed credentialing deadline and pays it to the provider. A contracting entity "shall complete the credentialing process not later than ninety days after the contracting entity receives that credentialing form." Miss it and the entity is liable for one of two things: "a civil penalty payable to the provider in the amount of five hundred dollars per day, including weekend days," running from day 91 until the application is granted or denied, or retroactive reimbursement under the contract terms for services provided over the same period. The payer chooses which, and "shall inform the provider of the contracting entity's selection." Ohio also lets you file before your start date: the entity "shall allow the provider to submit a credentialing application prior to the provider's employment."

Ohio Revised Code § 3963.06 · checked Jul 2026 · everything else about Ohio

36 O.S. § 4405.1 gives commercial health benefit plans 45 calendar days to credential on a clean application (10-day incompleteness notice, PSV initiated within 7 days, 180-day hard cap on the whole process), and its distinctive lever is subsection (F): within 31 days after credentialing, the plan must consider the provider in-network for reimbursement purposes. Approval is not billable until loaded; use the 31-day clock. No provisional-credentialing or retro-pay clause (weaker than Indiana or Arizona), and BCBSOK discontinued its voluntary provisional credentialing effective July 1, 2026, expect longer commercial go-lives.

36 O.S. § 4405.1 via kb/states/ok.md · checked Jul 2026 · everything else about Oklahoma

Oregon's lever is pay-while-credentialing: ORS 743B.454 requires insurers to approve or reject a complete application within 90 days AND to pay all covered claims for services provided during the credentialing period. A provider joining an in-network group must be paid at the in-network rate on the in-network schedule (clawback to the group if credentialing ultimately fails), and claims submitted within 6 months after the period can't be denied for timely filing. HMOs are excluded from the definition. Bill during the window on every clean Oregon commercial application; for group joins, demand the in-network rate.

ORS 743B.454 (Oregon Legislature) via kb/states/or.md · checked Jul 2026 · everything else about Oregon

R.I. Gen. Laws § 27-18-83 requires health plans to decide credentialing within 45 calendar days of a complete application, and carries the sharpest go-live clause in the country: billing privileges are effective the NEXT BUSINESS DAY after approval. Also: complete-application confirmation within 5 business days, automated status updates at least every 15 calendar days, written denial reasons, 7-business-day turnaround on minor demographic changes, and a conditional-approval track for resident graduates. Hold RI plans to the 45-day + next-day-billing pair.

RIGL § 27-18-83 (official text) via kb/states/ri.md · checked Jul 2026 · everything else about Rhode Island

Tenn. Code § 56-7-1001 requires a commercial health insurance entity to notify a provider of the result of a clean CAQH credentialing application, and whether it will contract, within 90 calendar days. It is a decision-deadline law, not a pay-while-pending law: it does not authorize in-network billing before the decision, and the statute does not establish that it reaches the TennCare Medicaid MCOs.

Tenn. Code § 56-7-1001 via kb/states/tn.md · checked Jul 2026 · everything else about Tennessee

Utah Code § 31A-45-304(1)(d): "Upon receipt of a provider application and upon receiving all necessary information, a managed care organization shall make a decision on a provider's application for participation within 120 days." Subsections (1)(e)/(1)(f) set mandatory and prohibited rejection grounds, and § 31A-45-303(6) gives hearing rights. This is a decision clock only. Utah has no pay-during-credentialing or provisional-pay mechanic, so don't promise interim payment.

Utah Code § 31A-45-304 (Health benefit plan networks, provider applications) · checked Jul 2026 · everything else about Utah

18 V.S.A. § 9408a requires an insurer to act upon and FINISH the credentialing process within 60 calendar days of receiving a completed application, with deficiency notices due within 30 business days. And it statutorily mandates the CAQH application as Vermont's uniform credentialing form. Use it on Vermont's commercial payers (BCBSVT, MVP); DVHA/Medicaid is not an 'insurer' under this chapter.

18 V.S.A. § 9408a (official statute text) via kb/states/vt.md · checked Jul 2026 · everything else about Vermont

W.Va. Code § 33-45-2(a)(11) gives commercial insurers four months from a completed application to accept or reject a provider (extendable three months for PSV delays). And, unusually, mandates that a provider who renders services during the credentialing period SHALL BE PAID for them, with the insurer able to recoup only if credentialing is ultimately denied. Bill services rendered while pending, and reserve for clawback until approval lands.

W.Va. Code § 33-45-2 via kb/states/wv.md · checked Jul 2026 · everything else about West Virginia

W.S. 26-56-102 (applying to credentialing applications submitted on or after 2025-07-01) requires a receipt notice within 7 calendar days, an incompleteness notice within 30 calendar days, and that a health carrier "conclude the process of credentialing an applicant within sixty (60) calendar days" after the carrier receives the application. The clock pauses while the application is incomplete. There is no approval mandate.

Wyoming Statutes Title 26 (Insurance Code), official LSO compilation · checked Jul 2026 · everything else about Wyoming