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Build a Provider Credentialing Checklist and Tracker

Prompt
You are a healthcare practice administrator handling provider credentialing. Create a comprehensive credentialing checklist and tracking system for onboarding a new provider or re-credentialing an existing one.

Practice details:
- Practice name: {{practice_name}}
- Provider being credentialed: {{provider_name}}
- Provider type: {{provider_type}} (MD, DO, NP, PA, therapist, etc.)
- Credentialing type: {{credential_type}} (initial credentialing or re-credentialing)
- Insurance panels to join: {{insurance_panels}}
- State: {{state}}
- Hospital privileges needed: {{hospital_privileges}} (yes/no, which hospitals)

Create:

1. **Master Credentialing Checklist**
   Organize by category:
   - **Personal Documents:** State license, DEA certificate, malpractice insurance, board certification, medical school diploma, residency completion, NPI number, CAQH profile, CV, government-issued ID
   - **Background & Verification:** Background check, OIG/SAM exclusion check, NPDB query, malpractice claims history, references (typically 3 peer references)
   - **Insurance Enrollment:** Application for each listed insurance panel, CAQH attestation, group/individual NPI, tax ID, w-9
   - **Hospital Privileges** (if applicable): Application, proctoring requirements, bylaws review
   - **Practice-Specific:** Employment agreement, malpractice tail coverage (if applicable), orientation completion

   For each item: document name, who's responsible (provider or admin), typical processing time, and status field (not started / in progress / submitted / approved).

2. **Timeline Template** — A week-by-week credentialing timeline showing when to start each category. Note: insurance credentialing typically takes 60-120 days. Start everything as early as possible.

3. **Follow-Up Tracker** — Simple tracking format for each insurance company: date submitted, confirmation number, expected processing time, follow-up dates (every 2 weeks), current status, contact person at the payer.

4. **Expiration Tracking** — List of all documents with expiration dates. Flag anything expiring within 90 days. Set up a rolling reminder system.

This is administrative work that can make or break a new provider's start date. Missing one document can delay everything by weeks.

About This Prompt

Creates a complete credentialing checklist, timeline, follow-up tracker, and expiration management system for onboarding or re-credentialing providers.

How to Use

  1. 1. Identify whether this is initial credentialing or re-credentialing.
  2. 2. List all insurance panels the provider needs to join.
  3. 3. Generate the checklist and customize for your state's specific requirements.
  4. 4. Start the process at least 90-120 days before the provider's target start date.
  5. 5. Assign responsibilities clearly between the provider and your admin team.
  6. 6. Follow up with insurance companies every 2 weeks — do not wait for them to call you.
  7. 7. Set up calendar reminders for all expiration dates.

Expected Output

A four-component credentialing system: master checklist with status tracking, week-by-week timeline, insurance follow-up tracker, and document expiration management.

Model-Specific Tips

Better at realistic timeline estimates and practical follow-up advice.

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