Delegated credentialing is the highest-leverage move a mid-market BH group can make. Once a payor delegates, you skip their credentialing process entirely — you credential providers yourself and they accept it. Optum and Carelon both offer this if your group is NCQA-compliant.
What goes in the binder
NCQA's standards (specifically CR 1–6) require:
- Primary source verification of license, DEA, board cert, education, work history
- NPDB query within 180 days
- OIG and SAM.gov screening within 30 days
- Provider attestations (clinical privileges, signed within 365 days)
- Sanctions and disciplinary action screening
- Re-credentialing within 36 months (24 months for some payors)
Generating the binder in CredTek
- Open the provider's record at
/providers/[slug]?tab=documents. - Scroll to Generate audit binder.
- Click — CredTek assembles a 12-30 page PDF (length depends on tenure) with every required artifact in NCQA's expected order.
- Review and either download for your records or send directly to the payor's delegated credentialing reviewer.
For the whole roster (full audit)
When a payor (or NCQA itself) audits your delegated arrangement,
you'll need binders for a sampled subset of your providers.
/ops/audit shows the audit log; we'll add a roster-wide
binder export in a future release. For now, the per-provider binder
is the fast path.
Why this matters financially
Delegated credentialing typically takes 30-60 days off time-to-active per provider for that payor (you skip their credentialing committee). For a 200-provider group adding 40 providers a year, that's roughly $300K in pulled-forward revenue.