Free guide. Every rule links to its source.
Adding a new clinician to your group
A new hire does not join your insurance contracts automatically. Medicare needs a reassignment, and each commercial plan has its own process, even when the group already has a contract.
Checked against each source on October 12, 2026. Rules change, so confirm with the payer or agency before you file.
Medicare: reassignment on the CMS-855I
- One form now. CMS: "All reassignment actions should now be reported via the CMS-855I. The CMS-855R (Reassignment of Medicare Benefits) form has been discontinued."
- Both must be enrolled. "Both the individual practitioner and the eligible organization/group must be currently enrolled (or concurrently enrolling ...) in the Medicare program before the reassignment can take effect."
- Online or paper. Changes, including adding a reassignment, can be made through PECOS or the paper form.
Sources (checked Oct 12, 2026)
Each commercial plan separately
- Example: UnitedHealthcare says that "even though you are joining a practice that has a UnitedHealthcare agreement in place, you'll still need to complete the onboarding process before you can see patients as an in-network provider," through its Onboard Pro tool.
- Virginia's 60-day rule. When the practice already contracts with a state-regulated carrier, Virginia law says the carrier "shall approve or deny new provider applicant credentialing applications within 60 days of receiving a completed application," and pending-period claims are paid at the in-network rate no later than 40 days after the clinician is credentialed and contracted. The clinician must give patients advance notice that an application is pending.
- CAQH first. Get the new clinician's CAQH profile complete, attested and authorized for each plan before applying.
Sources (checked Oct 12, 2026)
Start the week they sign
Each plan runs on its own clock, so the order and the start date matter. We handle roster adds for the practices we work with and send a written status on every plan each Friday.
More guides
- Virginia payer enrollment guide: Medicare, Virginia Medicaid and the commercial plans, in order.
- Virginia Medicaid enrollment: DMAS PRSS enrollment and the five Cardinal Care plans.
- How long credentialing takes in Virginia: Each payer's own published estimate, and Virginia's 60-day rule.
- CAQH re-attestation: Every 120 days, and why a plan may not see your profile.
- Medicare revalidation: Due dates, notices, and what happens if you miss one.
- Medicare effective date: When billing starts, and the 30-day look-back.
- Type 1 vs Type 2 NPI: Which NPI you need, and choosing a taxonomy code.
- Credentialing readiness checklist: What to have ready before you apply (interactive).
We file it, follow up, and report every Friday.
We prepare and file each application within 5 business days of a complete packet, follow up with each payer, and send you a written status report every Friday. Nobody can promise an approval or a date; the payer decides both.
This page is general information, not legal advice. Rules and payer processes change; always follow the payer's or agency's current instructions. Payer, agency and product names belong to their owners and are used only to describe what each step involves.