Genesis Physicians Group Credentialing and Health Plan Enrollment journey

Steps in Your Credentialing Process & Timelines

  1. Credential Verification: Your credentials will be verified in line with NCQA, CMS, Texas Department of Insurance, and Health Plan standards.
  2. Peer Review: The Genesis Credentialing team will submit your profile to the Genesis Physicians Group Peer Review Committee for a formal review and approval process. 
  3. Timeline: The credentialing phase typically takes 4-6 weeks, marking roughly 25% of the overall process to secure your HealthPlan effective dates.
  4. Enrollment: Our Enrollment team will then actively engage with HealthPlans to finalize your effective dates during the subsequent phase.

Ongoing Credentialing Cycle

Your credentials will be reverified every 3 years.

  • In between re-credentialing cycles, Genesis team conducts ongoing monitoring as per NCQA, CMS, and HealthPlan guidelines to maintain your HealthPlan enrollment and ensure there are no disruptions in your revenue cycle.
  • It’s vital to continue keeping your CAQH profile current to aid in the ongoing monitoring processes.

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