How to use the credentialing wait period to build a stronger practice

Key takeaways 

• Insurance credentialing typically takes 60–150 days or more depending on the payer, but the wait period can be used strategically to build your practice. 

• An incomplete CAQH ProView profile is one of the most common causes of credentialing delays — confirm your profile is complete and attestation is current before anything else. 

• Credentialing only affects insurance reimbursement. You can see clients as a self-pay or out-of-network therapist while you wait. 

• The wait period is the best time to set up your EHR, build note templates, finalize clinical paperwork, and set your fee schedule — tasks that become much harder once your caseload fills. 

• Start building your referral network early. Introductions to primary care physicians, school counselors, and EAP coordinators are easier before you need clients than after. 

• Plan for at least 60–90 days past your credentialing approval before insurance reimbursements become consistent — there’s a claims processing cycle on top of the credentialing timeline. 

• Targeted continuing education (EMDR, perinatal mental health, DBT) during the wait adds real value. Generic CE courses generally don’t. 

You submitted your application. You followed up. Now you wait.

For many therapists, the credentialing wait is one of the most stressful stretches of their early career, not because anything is going wrong, but because so little feels within their control. Insurance panels move slowly. Timelines are vague. And every week without an approval feels like a week without income.

But credentialing has a finish line. It’s a defined, temporary process typically measured in weeks or months, not years, which means you can plan around it. The therapists who arrive at their first credentialed session feeling ready are usually the ones who treated this window as a launch phase, not a pause.

Here’s what’s worth doing with that time.

Understand what you’re actually waiting for

Credentialing is the process by which insurance payers verify your license, education, malpractice history, and clinical background before agreeing to reimburse you for services. Most of it runs through your CAQH ProView profile, which consolidates your credentials for participating payers.

Timelines vary by payer and by how complete your application is. Some commercial payers complete the process in 60 days; others routinely take longer. Medicare and Medicaid credentialing timelines are governed by separate processes and vary by state. For a deeper look at how credentialing, contracting, and enrollment differ, and why the distinction matters see our full guide “Understanding credentialing, contracting, and enrollment for therapists“.

The clearest thing you can do right now is confirm your CAQH profile is complete and attestation is current, as incomplete profiles are one of the most common causes of delays.

Not sure if you should get credentialed by yourself or through a group practice? Here’s our case for individual credentialing. 

Get your practice infrastructure in place

This is the single best use of the wait period, because you will not have this kind of uninterrupted time again once clients are on your schedule.

Set up your EHR and intake workflows

Build your note templates, configure your scheduling, test the client portal, and set up any automated appointment reminders. If you’re going to use a platform like TheraNest, the wait period is the right time to learn it, not during your first week of sessions when the pressure is higher.

Draft and finalize your clinical paperwork

Informed consent forms, HIPAA notices, intake questionnaires, and financial agreements take longer to write well than most clinicians expect. The APA’s ethics resources and your state licensing board’s guidelines are worth reviewing as you draft these. Getting feedback from a colleague or supervisor now is far easier than revising forms mid-caseload. 

Set your fee schedule

Decide on your self-pay rate, your sliding scale range if you plan to offer one, and how you’ll handle cancellations. Having this settled before your first consultation prevents awkward, on-the-spot decisions. You’re also less likely to upset clients since you’ll have a policy from the start, instead of creating one later. 

Consider seeing clients now, on your terms

Credentialing only affects insurance reimbursement. It doesn’t prevent you from practicing. While you’re waiting on panel approval, you can see clients as a self-pay or out-of-network provider.

Self-pay gives you full control over scheduling, rates, and documentation. Out-of-network billing means clients pay your full fee and submit a superbill to their insurer for partial reimbursement — a workable arrangement for clients with out-of-network benefits, though not every client will have them or be able to cover the upfront cost. If you’re still not sure which to pick, we have eight questions that’ll help you decide.

Neither approach replaces a full insurance panel for most practices, but both are legitimate options worth offering to clients who can work within those terms. The NASW’s private practice guidance covers billing structures in more detail for social workers; the APA’s practice resources offer comparable guidance for psychologists and licensed counselors.

Build your referral network before you need it

Referrals are easier to cultivate when you’re not desperate for them. Use the wait period to introduce yourself to primary care physicians, pediatricians, school counselors, and employee assistance program coordinators in your area. A brief, direct email or a short in-person introduction is enough: you’re not asking for anything yet, just making the connection.

Join your local or state chapter of a professional association if you haven’t already. The American Mental Health Counselors Association, NASW, and state-level groups all offer professional directories and networking opportunities that translate into referrals over time.

Invest in targeted continuing education

Avoid the impulse to take any CE course just to feel productive. Be deliberate: identify a clinical population or modality that would make you more marketable in your specific area and pursue training there. An EMDR training, a perinatal mental health certification, or a structured course in DBT skills has real value. Generic wellness seminars generally don’t.

Check your state licensing board’s requirements as well. Some states allow CE credits earned during this period to count toward your first renewal cycle. It’s worth confirming before you start.

Protect your finances during the wait

Be realistic about cash flow. Insurance reimbursements don’t arrive the moment credentialing clears: there’s a claims submission and processing cycle on top of the credentialing timeline. Plan for at least 60–90 days past your approval date before insurance revenue becomes consistent.

If you have any flexibility, reduce discretionary expenses now. Look at whether any bridge income, like part-time clinical work, or telehealth platforms that don’t require panel membership, or contract work, is feasible during the wait.

You will get credentialed. Arrive ready

The wait is real, and the financial pressure is real. But the therapists who feel most prepared on the other side of credentialing are the ones who used this time to build the infrastructure, relationships, and clarity that a busy caseload makes harder to develop.

Your first credentialed session is coming. The question is how ready you’ll be when it does.