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Switching Credentialing Companies Without Starting Over

You can change credentialing companies in the middle of a project without refiling anything. The applications already at the payers belong to you, and the new company only needs three things to pick them up: an accurate list of what is open, access to the systems those applications live in, and a change of authorized contact at each payer. Refiling is the expensive mistake, because a duplicate can be returned or can split your file in two. This guide covers the handoff in the order it should happen.

Start With a Tracking Sheet

The first thing to get from the old company is a list of every application, one row per provider per payer. Without it, the new company has to rebuild the history from payer calls, which is slow and is how duplicates happen. Each row should show:

• Payer and product (for example a commercial plan, its Medicare Advantage plan, or a behavioral health vendor)
• Provider name, NPI, and the group Tax ID and Type 2 NPI if the application is for a group
• Status: not started, submitted, in review, more information requested, approved, contract pending, or denied
• Date submitted, payer reference or tracking number, and the date and outcome of the last follow-up
• Any open request from the payer, with its due date

Ask for copies of what was submitted and every letter or email from the payer. An approval letter with an effective date is the proof you will need if a payer later says it has no record.

Take Back CAQH (DataSpring) Access

Your CAQH (DataSpring) profile is the shared application most commercial plans read, and it belongs to you. Grant the new company access, remove the old company, and change the credentialing contact on the profile so payer questions go to the people now doing the work. Then check the attestation date and the list of authorized plans. Payers such as Evernorth require an attestation within the last 120 days and their own authorization before they will review, and Aetna asks you to designate it as an authorized plan so it can pull the application.

Payer Portals and Availity

Most commercial plans route enrollment status and claims tools through Availity Essentials or their own portal. Each organization has one primary Availity administrator who adds and removes users. If the old company set up the account, make sure the administrator on record is someone at your practice before that company's access is removed; changing the primary administrator goes through Availity Client Services. Do the same for any payer portal or behavioral health portal, such as the Evernorth Provider Portal, where logins were created in your name.

Medicare: Change the Surrogate, Not the Application

For Medicare, the handoff happens in the CMS Identity and Access Management System, not in PECOS. An individual provider approves the new company's surrogate connection request, and a group's Authorized Official adds the new company as a surrogate. Remove the old company's connection at the same time. The application in PECOS keeps its tracking ID and its place in line. Watch the clock on anything already returned for correction: CMS says an application returned for corrections must be resubmitted within 30 days or it will be rejected.

What Not to Refile

Do not resubmit an application that is already at a payer. Federal rules let the Medicare contractor return an application that is an exact duplicate of one already processed, being processed or pending, and a returned application cannot be appealed. Commercial payers do not publish one rule for duplicates, so treat a second submission as a risk: it can create a second file, restart a review, or leave the payer unsure which contact to answer. Call the payer, confirm what it has on file under the reference number, and update the contact on the existing application instead. Refile only when the payer confirms the original was closed, withdrawn or denied.

Handoff Checklist

1. Tracking sheet received and checked against your own records
2. Copies of submitted applications, approval letters and open payer requests
3. CAQH (DataSpring): new company added, old company removed, credentialing contact changed, attestation current, each payer authorized
4. Availity and payer portals: practice holds the administrator role, new company added, old company removed
5. CMS I&A: new surrogate approved, old surrogate removed, open development requests noted with due dates
6. Each payer told of the new contact on the existing application, by reference number
7. Written confirmation from the old company of anything it still considers in progress

How PECS Takes Over Open Work

PECS starts from your tracking sheet, confirms each open application with the payer before doing anything, and files only what is genuinely missing. Applications we pick up are priced per application at our published prices, and every one is followed up on a regular schedule with its status visible at pecs.health/status. For how long each payer typically takes once the handoff is done, see how long credentialing takes and credentialing timelines by state and payer.

Frequently Asked Questions

Sources: 42 CFR 424.526 (returned Medicare applications) · First Coast: reasons for immediate returns · CMS PECOS 101 · Availity administrator guide · Evernorth: join the network · Aetna: join the network.

By the PECS credentialing team. Updated October 2026.