Subject: Credentialing quote request for a [specialty] practice in [state]

Hello,

We are comparing credentialing services. Here is what we need.

ABOUT US
- Providers: [number and license types, such as 2 MDs and 1 NP]
- States: [states]
- Practice entities and locations: [how many of each]
- Insurance plans we want to join: [list each plan and product]
- Work already started: [none / applications filed / already in network with some plans / problems to fix]
- Help we want: [first-time enrollment / adding providers / ongoing upkeep / taking over stalled applications]
- Target opening or start date: [date, for planning only]
- Billing: [in-house / billing company / still deciding]

PLEASE ANSWER IN WRITING

1. What is your price for this exact list? What is the unit (per plan, per provider, per application, or per month)?
2. How many billable units is our list? Do the practice's application and each provider's application count separately?
3. Are Medicare and Medicaid priced the same as commercial plans?
4. Are there setup fees, monthly fees, minimums, or outside fees you will pass on to us?
5. What does the price include? Please answer yes or no for each: profile setup in the CAQH Provider Data Portal, filing applications, fixing rejected or incomplete applications, follow-up with the plan, contract paperwork, fee schedule review, rate negotiation, EFT and ERA enrollment.
6. How many business days after you get our documents will you file each application?
7. How often will we get a written status update? Can we see the status of every application ourselves?
8. When a plan approves us, what proof will you send us (effective date, any required executed contract or addition to an existing agreement, and the locations and tax ID it covers)?
9. What happens if a panel is closed, a plan says no, or an application is rejected because of your mistake? What do we still owe?
10. What upkeep is included, and for how long? What do re-attestation, recredentialing, and Medicare revalidation cost after that?
11. Which CAQH, Medicare PECOS, and payer portal accounts will we control? Will you use authorized access under your own account where supported? How do we revoke your access and get copies of our applications, status records, and contracts if we leave?
12. What is the contract length and the notice to cancel? Do you refund work you have not filed yet?
13. Do we have to buy billing from you or change our software?

We know no one can promise that a plan will accept us or how fast it will decide.

This email has no patient information, Social Security numbers, or passwords. We will send application documents later, through the secure method we agree on.

Thank you,
[name, role, practice, phone or email]