Telehealth is expanding rapidly in 2026, but cross-state licensing rules remain strict. This guide breaks down state requirements, compact options, telehealth-specific registrations, and the compliance pitfalls most healthcare groups overlook.

Interstate compacts are rapidly transforming multistate medical licensing, and 2026 will mark the largest expansion yet. With more states joining the IMLC, APRN, and PT compacts—and a new PA Compact now underway—healthcare organizations must understand how these agreements streamline cross-state practice, reduce administrative burden, and accelerate provider onboarding in a growing telehealth era.

For any provider navigating the complex world of insurance credentialing, CAQH ProView is the single most critical tool in your toolkit. Every commercial payer, large or small, relies on accurate and up-to-date CAQH data to credential providers and ensure claims are processed correctly. Yet, many providers struggle to create their CAQH profiles correctly, miss important documentation, or fail to verify information, causing delays or denials from private payers.

This guide walks you step-by-step through creating your CAQH account, completing and updating your profile, submitting documents, and verifying your information with private payers. You’ll learn insider tips to avoid common errors, understand how payer-specific requirements interact with CAQH, and see how to maintain your profile proactively so you stay compliant. Whether you’re a solo practitioner, part of a small clinic, or managing multiple provider accounts in a group practice, this post will help you save time, avoid rejections, and ensure your credentialing process is smooth and efficient.

When a fast-growing telehealth startup set out to credential 60 providers across 22 states, their team assumed digital healthcare meant faster approvals, easier processes, and universal rules. Instead, they found themselves blocked by insurance panels, rejected by payers for preventable errors, and stuck in a bureaucratic maze where telehealth-specific regulations vary dramatically from one state to another. Their launch stalled for 13 costly months, burning nearly half a million dollars in operating expenses while they waited for approvals that would never come.

This case study follows the exact moment the leadership team realized they were stuck, the structural system errors that caused their delays, and how Rivon Health rebuilt their entire licensing and credentialing infrastructure from the ground up — ultimately reducing a projected 14–16 month timeline to 4 months. If you’re a telehealth organization or a digital health CEO, this is the hidden story behind why so many virtual care startups fail quietly — and how the right credentialing partner can save millions in lost revenue, investor confidence, and growth opportunity.

The medical licensing and credentialing landscape is undergoing the biggest transformation in more than a decade. Providers are moving across states at record levels, telemedicine is expanding, and commercial payers are tightening their enrollment requirements—all while state boards and Medicare contractors struggle with outdated systems and staffing shortages. As a result, credentialing timelines are longer than ever, costing medical groups hundreds of thousands of dollars in delayed revenue and preventing providers from seeing patients for months.

This deep-dive explores the major trends shaping 2025, including digital identity verification, IMLC expansion, evolving DEA telemedicine rules, stricter CAQH standards, and increased Medicare and Medicaid scrutiny. It also outlines the operational steps medical groups must take to stay compliant and accelerate onboarding, from adopting automation and standardizing provider data to using professional credentialing teams instead of internal admin staff.

The takeaway is clear: credentialing is now a strategic function—not a clerical one. Organizations that modernize their processes and partner with experts like Rivon Health are positioning themselves for efficiency, compliance, and long-term growth in a rapidly changing healthcare environment.

Many providers underestimate the complexity of licensing and credentialing until they attempt it on their own—and find themselves trapped in a maze of outdated systems, inconsistent payer rules, and time-consuming paperwork. This case study follows Dr. Ashley Ramirez, a physician who spent six months attempting to obtain her state license, update her DEA, enroll in Medicare, and complete commercial payer credentialing. The delays cost her more than $78,000 in lost income and 176 hours of administrative labor, while her new medical group struggled to keep her position open and cover patient load with temporary providers.

Once Rivon Health stepped in, everything changed. Our team rebuilt her applications, corrected critical errors, escalated with state boards and payers, updated CAQH properly, and completed her entire licensing and credentialing workflow in just 60 days. This case study highlights the financial, operational, and emotional toll of doing credentialing alone—and the powerful impact that expert intervention can have. For medical groups and providers alike, this is a clear picture of what happens when you try to navigate the most fragmented administrative process in healthcare without specialized support.

Payer enrollment has quietly become one of the most dangerous operational risks in U.S. healthcare. What once took 30–60 days now routinely takes 90–180 days or more as Medicare, Medicaid, and commercial insurers tighten fraud controls, add verification layers, and increase compliance requirements. The result is a hidden revenue leak that costs medical groups tens of thousands to hundreds of thousands of dollars per provider—often without leadership realizing where the loss originated.

In 2025, payer enrollment is no longer a formality; it is a high-stakes, high-complexity function requiring expertise, proactive monitoring, and precise documentation. Most practices are not equipped for this shift. They rely on manual spreadsheets, outdated workflows, and understaffed credentialing teams expected to navigate 20–40 payer systems while managing constant rule changes and unpredictable timelines.

This post breaks down why payer enrollment has become so difficult, how delays damage revenue and provider morale, and what medical groups must do immediately to modernize. With payers imposing stricter standards and audits expanding every year, organizations that fail to upgrade their processes will experience lost contracts, compliance issues, and major financial disruption. Those that adapt now will gain stability, speed, and a competitive edge.

The U.S. healthcare system is experiencing a silent emergency: credentialing delays that are shutting down revenue, blocking provider onboarding, and overwhelming medical groups that still use outdated processes. What once took 60–90 days now routinely takes 120–180 days as state medical boards, Medicare MACs, and commercial payers struggle with increased volume, stricter verification standards, and antiquated systems.

In 2025, credentialing is no longer a clerical function—it is a compliance-critical operational pillar that directly impacts patient access and organizational financial stability. Providers who are not properly credentialed cannot bill, cannot prescribe, and often cannot even begin work, costing practices tens of thousands of dollars per month. Yet many organizations still rely on email threads, spreadsheets, paper files, and single-staff workflows that simply cannot keep up with today’s demands.

This article unpacks the root causes of the credentialing crisis, the financial and regulatory consequences for medical groups, and the modernization strategies organizations must adopt immediately to prevent multi-month onboarding delays. As credentialing enters a new era of digital identity verification, automated documentation checks, and multi-state provider mobility, medical groups that evolve now will gain a major advantage—while those that don’t will fall further behind.