Starting your own dermatology practice is an exciting milestone, but before you can begin seeing patients and receiving reimbursements from insurance companies, you need to go through the essential process of credentialing. Credentialing is the system insurance carriers and hospitals use to verify your education, training, licensure, and professional history. While it can feel overwhelming at first, understanding the steps can help you move through it more efficiently and prevent unnecessary delays that affect your revenue.
At its core, credentialing involves verifying your medical school, residency, and fellowship training, along with your board certification, state medical licenses, DEA registration, malpractice history, and work experience. Once this process is complete, you can join insurance panels and obtain hospital privileges. Without proper credentialing, you won’t be able to bill insurers for your services, which makes it a critical step in setting up your practice.
One of the first things you should do is get your CAQH (Council for Affordable Quality Healthcare) profile in order. Most insurance companies rely on CAQH as a centralized database for credentialing, so keeping it updated with accurate, verified documents will save you time when applying to multiple carriers. At the same time, make sure you have your practice’s Employer Identification Number (EIN) for tax purposes and a Type 2 National Provider Identifier (NPI), in addition to your personal NPI.
Next, take time to research which insurance panels are most relevant for your region. Dermatology panels can sometimes close, so apply broadly and as early as possible. Each insurer has its own application process, often linked to your CAQH profile, and you’ll need to provide supporting documentation such as malpractice insurance certificates, state licensure, hospital privileges, and your CV. Credentialing can take anywhere from 60 to 120 days or more, so it’s important to track timelines carefully. Using a spreadsheet or practice management software to monitor applications and following up regularly can prevent your paperwork from getting stuck in review.
Credentialing doesn’t end once you’re approved. Most insurance carriers require re-credentialing every two to three years, so keeping your CAQH profile current and maintaining your malpractice coverage is essential to avoiding disruptions in reimbursement. To make the process smoother, start early—ideally three to six months before your practice opens—stay organized by scanning and saving all important documents, and consider outsourcing to a credentialing consultant if your schedule doesn’t allow you to manage the process directly. Consistent follow-ups with carriers can also keep your applications moving along.
Although credentialing may not be the most glamorous part of starting a dermatology practice, it is one of the most important. By staying proactive, organized, and aware of the timelines involved, you can set up your practice for success and ensure that you’re able to generate revenue without interruption. Credentialing may feel like a hurdle, but it’s one you can clear with preparation—and it’s a necessary step on your path to building a thriving dermatology practice.
