Texas Payer Enrollment & Credentialing Workflow

PayerProviderProvider TypePlan / Line of BusinessEnrollment TypeTarget Submission Date

Enrollment Progress0%

0 of 40 required workflow checks

Determine the Enrollment Pathway

Plan / product / line of businessProvider typeEnrollment entityPortal / submission method

Contracting requirement confirmed*Credentialing requirement confirmed*Texas Medicaid enrollment checked, when applicable*Correct application / submission pathway confirmed*Current payer portal or submission method confirmed*Enrollment pathway confirmed*

Gather Required Documentation

Track documents that apply. Confirm the payer’s current attachment requirements before treating any item as required.

Document	Expiration date	Status
W-9
Professional license
Malpractice / professional liability insurance
DEA documentation, when applicable
Board certification, when applicable
CAQH documentation
Practice / facility documentation
Payer-specific attachments

Document notes

Complete the Application

Correct application selected*Provider information matches source records*Practice information matches source records*Required fields completed*CAQH information current, when applicable*Required signatures completed*Required attachments included*Contracting documentation completed, when applicable*Effective-date requirements reviewed*

Payer-specific instructions

Submit & Track

Submission dateSubmission methodConfirmation / reference numberPayer contactFollow-up dateCurrent statusDeficiency received?Additional information requested?Resubmission dateApproval dateEffective date

Issue / next step notes

Maintain Enrollment

Maintenance item	Applicable due date
Recredentialing
Revalidation
License expiration
Insurance expiration
CAQH re-attestation
Provider demographic changes
Practice location changes
Payer changes
Other payer-specific renewal requirements

INTELLIGENCE

ElaraNav Payer Intelligence Layer

Select a payer above to check available ElaraNav evidence. Generic workflow items are not payer requirements.

ElaraNav provides informational and operational guidance based on available payer documentation and verified field intelligence. Payer requirements can change. Users should confirm requirements with the applicable payer or official source before submission.