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DoxCredential — Built for Healthcare Practices

Provider Credentialing &
Payer Enrollment, Simplified

End-to-end credentialing management from initial application through re-credentialing. Track every license, affiliation, and payer enrollment in one place.

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60%
Faster Enrollment
Zero
Missed Expirations
100%
Digital Document Vault
NCQA
Standards Aligned
How It Works
Credentialing in 5 Steps
From onboarding a new provider to maintaining active payer enrollments, DoxCredential keeps every step organized and on track.
1

Provider Intake

Provider logs into their own portal and fills out their application — education, training, work history, and disclosures.

2

Document Collection

Upload licenses, DEA certificates, malpractice insurance, board certifications, and CME records to a secure vault.

3

Primary Source Verification

Track verification status for each credential. Flag gaps, discrepancies, and items pending verification.

4

Payer Enrollment

Manage applications to insurance networks. Track status, effective dates, and provider numbers for every payer.

5

Monitor & Re-Credential

Automated expiration alerts for licenses, certifications, and payer contracts. Never miss a renewal deadline.

Everything You Need to Credential Providers
A complete credentialing management system built into your EHR — no third-party software or spreadsheets required.
🎓

Education & Training

Track medical school, residency, fellowship, and continuing education. Record institution, degree, specialty, dates, and program directors for each entry.

CAQH Aligned
💼

Work History

Complete employment chronology with gap detection. Current and previous positions, addresses, dates, and reasons for leaving — with automatic gap flagging.

Gap Detection
🏧

Hospital Affiliations

Track admitting privileges at every facility. Privilege type, restriction status, temporary privileges, admission percentages, and current/historical affiliations.

Privilege Tracking
🛡

Malpractice Insurance

Current and historical malpractice policies with carrier details, coverage amounts (per-occurrence and aggregate), policy numbers, and self-insurance tracking.

Claims History
📜

Malpractice Claims

Document every claim and lawsuit: incident dates, allegations, carrier, settlement amounts, resolution method, injury description, and NPDB reporting status.

NPDB Tracking
👤

Professional References

Maintain peer references with full contact details, specialty, and verification status. Organized by priority for quick credentialing committee review.

Verification Ready
📍

Practice Locations

Manage all practice sites with addresses, NPIs, tax IDs, office hours, ADA compliance, languages spoken, and services offered. Flag primary vs. secondary locations.

Multi-Site

Disclosure Questions

Standardized attestation questionnaire covering license actions, criminal history, substance abuse, loss of privileges, and sanctions — with explanation fields for any "yes" answers.

Attestation
Provider Self-Service
Dedicated Provider Credentialing Portal
Providers log in to their own secure portal to complete applications, upload documents, and track their credentialing status in real time.
🔐

Secure Login

Each provider gets their own credentialing portal with unique credentials, separate from the main EHR.

  • Individual provider accounts
  • Password-protected access
  • Completion percentage tracker
  • Status dashboard on login
📄

Digital Document Vault

Upload, organize, and manage every credentialing document in a secure, searchable vault.

  • License & DEA certificates
  • Board certifications
  • Malpractice certificates of insurance
  • CV, diplomas, and transcripts
📚

CME Tracking

Log continuing medical education credits by category, accreditation body, and license state.

  • Credit hours by category (AMA, AAFP, etc.)
  • Accreditation number tracking
  • License state requirements
  • Running totals and reports
Network Management
Payer Network & Delegation Oversight
Manage your payer contracts, network memberships, delegated credentialing arrangements, and compliance audits from a single dashboard.
🏢

Network Accounts

Track every payer network your practice participates in. Store contract numbers, effective dates, participation types, and account status.

👥

Network Members

Manage providers enrolled in each network. Track member type, specialty, NPI, location, join date, and delegated credentialing status.

🤝

Delegated Credentialing

Track delegation agreements with scope, effective dates, review schedules, oversight mechanisms, and compliance status for each delegation.

📋

Compliance & Audits

Log compliance standards (NCQA, URAC, state), track audit findings, corrective actions, follow-up dates, and maintain evidence documentation.

Stay Audit-Ready, Always

DoxCredential maintains a complete audit trail for every credentialing action — who changed what, when, and why. Be ready for payer audits, NCQA reviews, and state surveys without scrambling for paperwork.

📋 NCQA Standards
🏦 URAC Aligned
🔒 HIPAA Compliant
📝 Full Audit Trail
🛡
Payer Enrollment
Insurance Enrollment & Contract Tracking
Track every payer application from submission through approval. Never lose revenue due to enrollment gaps or expired contracts.
📄

Application Tracking

Monitor enrollment applications by payer, status, submission date, and expected effective date. One view for all pending enrollments.

📅

Expiration Alerts

Automated notifications before licenses, certifications, malpractice policies, and payer contracts expire. Configurable lead times.

📈

Completion Tracking

Real-time credentialing completion percentage for each provider. Identify missing items at a glance and prioritize follow-ups.

📑

Contract Management

Store payer contract details including effective dates, fee schedule references, participation types, and renewal terms.

👥

Group Enrollment

Manage group-level payer accounts, facility information, group NPI, tax ID, and insurance details alongside individual provider enrollments.

🔍

Verification Status

Track primary source verification for every credential. Mark items as verified, pending, or flagged with reviewer notes.

Ready to streamline provider credentialing?

See how DoxCredential eliminates spreadsheets, missed deadlines, and credentialing bottlenecks for your practice.

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