Credential OS / Delegated Credentialing

Stop falling out of network on a missed 120-day attestation.

The fix is to stop treating three deadlines as three chores. Credential OS layers the CAQH ProView re-attestation, the delegated roster submission, and the delegation audit into one recurring engine so a provider who re-attests on Day 118 is already on the next roster and already audit-ready. One clock, three synchronized outputs, no provider quietly aging out mid-cycle.

Map your re-attestation cycle → See the three layers

120Days between required CAQH ProView re-attestations to keep a profile currentCAQH PROVIEW

36Month recredentialing cycle payers verify against under NCQA standardsNCQA CR

1×/yrMinimum delegation oversight audit an NCQA-accredited plan owes on your credentialingNCQA CR 8

60Months between Medicare enrollment revalidations tracked in the same cadenceCMS PECOS

The layered explainer

Three recurring cycles, stacked so nothing slips between them

A growing group does not lose network status from one big failure. It loses it from a stale attestation that quietly breaks a roster that then fails an audit. Read the stack top to bottom: each layer feeds the one beneath it.

CAQH ProView Re-Attestation Every 120 days

The source of truth. CAQH ProView requires each provider to re-attest that their profile is current on a rolling 120-day cycle. Let it lapse and the profile is flagged stale, so every payer pulling from CAQH sees expired data even though nothing about the provider changed.

Automated Day 90 and Day 110 reminders keyed to each provider's own attestation date
Expirables (license, DEA, malpractice COI, board cert) checked before re-attest, not after
Global authorization confirmed so delegated payers can keep pulling the profile

↓ feeds the roster ↓

Delegated Roster Submission Per payer cadence

Under a delegated credentialing agreement, your group, not the plan, credentials the providers and reports them on a roster. The roster is only as clean as Layer 01. A provider with a lapsed attestation belongs on an exception report, not a silent drop that surfaces as a denial three weeks later.

Roster built from the same live profiles, so add, term and demographic changes reconcile automatically
Each payer's file layout and submission window enforced instead of remembered
Effective dates and re-credentialing due dates carried on every line for the audit trail

↓ proven by the audit ↓

Delegation Oversight Audit Annual + reporting

An NCQA-accredited plan that delegates credentialing to you stays accountable for it. That means a mutually agreed delegation agreement, periodic reporting, and at least an annual audit of your files and process. The audit does not fail on missing paperwork when Layers 01 and 02 already produced it as a byproduct.

File-level evidence linked to each credentialing decision and its 36-month recredential date
Primary source verification timestamps preserved for the reviewer, not rebuilt for them
Delegation agreement obligations mapped to the artifacts that satisfy each one

The 120-day clock

What the engine is doing between re-attestations

Every provider runs their own 120-day loop. Credential OS acts on the loop instead of waiting for the deadline to arrive.

DAY 0

Attested

Profile confirmed current in CAQH ProView. Next re-attest date stamped on the provider record.

DAY 90

Pre-check

Expirables scanned. Any license, DEA or COI expiring before Day 120 is queued for refresh first.

DAY 110

Re-attest

Provider re-attests with clean data. The updated profile flows straight onto the next roster build.

DAY 120

Never stale

Deadline passes with the profile already current, so no payer ever pulls expired data.

Why it matters

The manual way versus the layered way

× Three disconnected spreadsheets

× Attestation dates tracked apart from roster dates apart from audit dates
× A lapsed 120-day attestation surfaces only when a claim denies
× Rosters rebuilt by hand each cycle, so drops and terms go unnoticed
× Audit season becomes a scramble to reassemble evidence after the fact
× Growth multiplies the misses because the work is per provider, per payer

✓ One layered engine

✓ One provider record drives attestation, roster and audit together
✓ Re-attestation acted on at Day 90, long before the profile can go stale
✓ Rosters reconcile automatically, exceptions flagged instead of dropped
✓ Audit evidence is a byproduct of the daily work, always current
✓ Adding providers adds rows, not risk

How Credential OS runs it

From attestation to audit-ready in one pass

Watch

Each provider's 120-day and 36-month clocks tracked continuously

Refresh

Expirables and CAQH re-attestation cleared ahead of the deadline

Roster

Clean profiles assembled into each payer's delegated roster format

Submit

Files delivered on the payer's window with effective dates attached

Prove

Every decision and PSV timestamp held ready for the annual audit

The guidelines we build to

Real standards, cited by name

Credential OS is designed against the published requirements your payers and accreditors actually hold you to.

Source of truth

CAQH ProView Re-Attestation Cycle

Providers must re-attest that their CAQH ProView profile is current every 120 days, and keep global authorization active, for participating payers to pull accurate data.

Delegation authority

Delegated Credentialing Agreements

A mutually agreed delegation agreement defines the delegated activities, the roster reporting cadence, and the oversight the plan retains when your group credentials on its behalf.

Oversight standard

NCQA Delegation Oversight (CR 8)

NCQA credentialing and recredentialing standards require accredited plans to evaluate delegated credentialing through periodic reporting and at least an annual audit, against the 36-month recredentialing cycle.

Also synchronized: CMS Medicare enrollment revalidation via PECOS on a 5-year cycle. Verify current cycle timing directly with CAQH, NCQA and CMS for each provider and payer.

Your providers should never age out of a network you already earned

Credential OS from ASP-RCM Solutions turns the 120-day re-attestation, the delegated roster, and the delegation audit into one engine that runs itself as you grow. Bring us your provider list and payer mix, and we will map the cycle for you.

Talk to the credentialing team →

ASP-RCM SOLUTIONS · CREDENTIAL OS · FRISCO, TX