What triggers NP credentialing denials?
What triggers NP credentialing denials? Common causes include incomplete apps (44% of cases), expired licenses/DEA/certifications, data mismatches (NPI, names, addresses), unexplained work gaps, or sanctions hits. Quality concerns or malpractice history trigger deeper reviews, but 25-30% resolve with context; payers must explain denials per NCQA rules. Administrative terminations (no response) hit 15%—treat denials as urgent […]
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