AWMB Credentialing Pipeline

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Credentialing Pipeline Tracker

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Credentialing Pipeline

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⬡ Pipeline

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📊 Reports

📋 Audit Log

⚙ Admin

Filter by Stage

◉ All Providers

📋 Intake

🔗 CAQH

✓ PSV

📨 Enrollment

📞 Follow-Up

✅ Approved

🔄 Ongoing / Active

⛔ Inactive

v2.0 · AWMB LLC

Credentialing Pipeline

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Live data from your pipeline — refreshes with every change

Pipeline Stage Breakdown

Upcoming Deadlines Next 90 days

Payer Enrollment Summary

Employee Management

Provider Intake Form Passcode

This 4-digit passcode protects the provider intake form (/cred/intake.html). Share it with new providers so they can submit their information.

Morning Alert Emails

These addresses receive the daily credentialing alert email (weekdays, 8am). Powered by the AWMB-Cred-Alerts Google Apps Script.

Add Provider

Provider Name *

Credential / Title

NPI Type 1 (Individual)

NPI Type 2 (Group/Org)

Individual PTAN

Group PTAN

AHCCCS Billing Provider ID

AHCCCS Rendering / Servicing Provider ID

Specialty

Practice / Group

Phone

Tax ID EIN SSN

Addresses

Home Address

Practice Address

Billing Address

Current Stage

Intake Date

Target Effective Date

Select Payers to Enroll

Notes

Uploaded Documents

No documents uploaded yet.

Update Payer Status

Status

Submitted Date

Effective Date

Follow-Up Date

Payer Contact / Rep

Lines of Business

List each plan or product separately.

Notes

No notes yet.

Ctrl+Enter to save. Notes are saved immediately.

Contracted Date

Date the provider contract was signed

Credentialed Date

Date credentialing was approved by this payer

Re-Credentialing Due Date

Auto-calculated when Credentialed Date is set — or override manually

Re-Cred Cycle

Update Credential

Expiration / Due Date

Auto-calculated from renewal date

Last Renewed Date

For CAQH: enter last attested date — expiration calculates automatically (+120 days)

Contracted Date

Date the provider contract was signed with this payer

License / Certificate Number

Second License (optional)

License Number 2

Expiration Date 2

License Type / Notes

Notes

Status Override

Use N/A if this credential doesn't apply to this provider.

Add Employee

Full Name *

Role / Title

4-Digit PIN *

Access Level

Active

Add Payer

Select Payer

Custom Payer Name