Practice Start-Up & Credentialing FAQ
From Licensing And Credentialing to Billing Setup, TriumpHealth Helps New Practices Hit the Ground Running
1. Why is credentialing essential when starting a new medical or dental practice?
Credentialing allows your providers and practice to bill insurance companies and receive in-network reimbursement. Without it, even licensed providers cannot legally submit claims to Medicare, Medicaid, or commercial payers.
TriumpHealth handles credentialing from day one, so you can open your doors fully compliant and revenue-ready.
2. What types of new practices does TriumpHealth support?
We work with:
- Solo practitioners launching their first office
- Multi-provider group practices or partnerships
- Dental practice start-ups (general and specialty)
- Behavioral health and therapy clinics
- Mobile or telehealth-only practices
- Urgent care and concierge care start-ups
- Franchise and private equity-backed clinics
No matter your specialty or structure, we tailor credentialing and startup services to your timeline, goals, and payer mix.
3. What credentialing and start-up services does TriumpHealth offer?
Our comprehensive start-up package includes:
Business & Compliance Setup
- NPI (Type 1 and Type 2) registration
- Group TIN/IRS EIN setup and registration
- State license, CLIA, and DEA support
- Credentialing timeline roadmap and launch planning
Credentialing & Payer Enrollment
- Medicare (855I, 855R, 855B/A) and Medicaid enrollment
- Commercial insurance credentialing (e.g., Aetna, UHC, BCBS, Cigna, etc.)
- CAQH profile creation and maintenance
- PECOS and EFT/ERA setup
- Payer portal registrations
- Contract tracking and credentialing dashboards
Add-On Support
- EMR/EHR consultation
- Medical billing service integration
- HIPAA compliance and Security Risk Assessment
- Website and branding consultation (via trusted partners)
TriumpHealth is your one-stop partner from credentialing to compliance to revenue cycle readiness.
4. When should we begin the credentialing process?
We recommend starting credentialing ~ 90–180 days before your planned opening date. Credentialing timelines vary by payer, and delays are common without proactive management.
TriumpHealth builds a custom credentialing launch calendar to ensure your applications are submitted on time, avoiding billing delays once you go live.
5. Can we begin credentialing if our lease or office setup isn’t finalized yet?
Yes, a physical address and copy of lease are required. The only exception is Telehealth only where we can use a home address as physical and PO box/ DHHL or virtual address for mailing. TriumpHealth guides you on:
- What information is required to start
- What can be updated later (e.g., lease, signage, phone)
- How to avoid having to refile with payers
We balance speed with compliance to keep your credentialing moving forward.
6. What types of payers should we credential with as a new practice?
Most providers credential with a combination of:
- Medicare
- Medicaid (and state MCOs)
- Major commercial payers: Aetna, BCBS, UHC, Cigna, Humana, and others
- TPAs, EAPs, or Workers’ Comp (based on specialty)
TriumpHealth helps you identify which payers are essential for your patient population and negotiate or opt out of contracts strategically.
7. Can you help with credentialing multiple providers in our new practice?
Yes. We manage credentialing for individual and group submissions, including:
- Onboarding and enrolling all providers
- Linking providers to your group TIN/NPI
- Tracking recredentialing and license expiration dates
- Ensuring each provider is linked to all approved payers
Whether you’re opening with two providers or ten, we streamline group onboarding from day one.
8. What are the biggest credentialing mistakes new practices make, and how do you help avoid them?
Common issues include:
- Submitting incomplete or inaccurate payer applications
- Delayed NPI or TIN setup
- Forgetting EFT/ERA registration
- Credentialing a provider without linking to the practice
- Not tracking revalidation or contract statuses
- Missing business license requirements as demanded by state
- Missing designation of tax shelter for new business i.e. PLLC, S. Corp. etc.
- Failure to obtain a fax number as is required for payer enrollment
- Failure to secure a business checking account
TriumpHealth helps avoid these issues with step-by-step onboarding, document tracking, and a credentialing concierge model.
9. Do you support credentialing across multiple locations or states?
Yes. We support:
- Multi-site start-ups and group practices
- State-specific Medicaid enrollment
- Credentialing of remote, hybrid, and telehealth providers
- Franchise-style credentialing templates for multiple providers
Our systems are built to scale with your growth, from a single office to a regional or national footprint.
10. How do we get started with TriumpHealth’s Practice Start-up and Credentialing Services?
TriumpHealth is your credentialing and launch partner, delivering a turnkey start-up experience that gets you credentialed, compliant, and cash-flow ready. To learn how we can help you set-up your practice Schedule a Consultation here. You can always contact us via email [email protected] or call us at (888) 747-3836 x0
Learn more about TriumpHealth Practice Start-up Services
Disclaimer:
The content provided by TriumpHealth is for informational purposes only and does not constitute legal, medical, or financial advice. Regulations and payer requirements may change; please consult a qualified professional for guidance specific to your situation. Click here to review our full legal disclaimer.
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