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Initial Enrollment - This usually means that payment is still required in order to activate the policy, but documents have been approved. Active - The first premium payment has been made and the policy is active.
Provider Enrollment (or Payor Enrollment) refers to the process of applying to health insurance networks for inclusion in their provider panels. For Commercial Insurance networks, this process involves two steps, 1) Credentialing and 2) Contracting.
The process of getting on an insurance panel is known as getting credentialed. During this process, the insurance company determines whether or not to accept you onto their panel of providers. Youll need to prove that youre qualified before youre invited to join.
Medicare typically completes enrollment applications in 60 90 days. This varies widely by intermediary (by state). We see some applications turnaround in 15 days and others take as long as 3 months.
Open enrollment is the time of year when everyone can apply for a plan through Covered California. This usually happens from November to January. Outside open enrollment, people who experience qualifying life events can apply during special enrollment.

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PECOS web applications (initial enrollment or change of information with no site visit) 95% must be processed within 15 days, paper-based applications (initial enrollment or change of information with no site visit) 95% must be processed within 30 days, and paper-based applications (initial enrollment or change of
In summary: Both are essential for a providers ability to practice medicine and receive reimbursement for services. The focus of credentialing is on clinical qualifications and quality assurance, while enrollment emphasizes administrative and financial aspects of the providers relationship with payers.
Initial Enrollment Period (IEP) The 7-month period when someone is first eligible for Medicare. For those eligible due to age, this period begins 3 months before they turn 65, includes the month they turn 65, and ends 3 months after they turn 65. Coverage begins the month after a person signs up during their IEP.

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