Credentialing With Erin Referral

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Credentialing With Erin Referral

By submitting this form you are agreeing to contact from Credentialing with Erin and/or Erin Stumpf via email, phone or text communication. Credentialing by Erin is one of our affiliate partners and by signing up with services with them - we may be compensated at no additional cost to you.

Needs to Get Credentialed

You will need the following to start your credentialing:

- Physical address (not your home)

- Business Name Established with the State

- TIN/EIN number from the IRS

- CAQH Updated

- Phone/Fax number

Credentialing Fees:

$185 per commercial insurance / per state / per provider

$370 per government insurance / per provider (State Medicaid, Medicare, Tricare)

Full Name *

Specialty / Credentials *

Email *

Phone Number *

How would you like to be contacted? *

Phone

Text

Required

Insurances to be Credentialed (With State) *

Any thing else you want us to know?

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