Last updated: Sep 18th 2025
Quick definitions
Credentialing (insurance‑agnostic): Verifying your providers' qualifications and practice details so they can participate with insurance carriers.
Enrollment (insurance‑specific): Linking an eligible, credentialed provider to a specific plan so claims can be billed in‑network.
How to choose plans (practice‑level)
In your Zaya portal:
Go to "Admin" on the left panel.
Click the link to update your insurance enrollment preferences.
Fill out the form and click Submit.
Note: Submitting this form replaces your previous preferences. If you remove a plan you were enrolled in, Zaya will send a termination notice for your providers to that insurance.
Medicare Advantage (simple rule)
You indicate your enrollment preference once for Medicare Advantage (MA).
When marked as enrolled, MA is added as an accepted plan only to the insurance plans where you’re already commercially opted in.
While you may choose to not enroll with a certain insurance altogether, you may not enroll with the Medicare Advantage product of an insurance without accepting their commercial product patients
To bill Medicare Advantage claims through Zaya, Zaya must obtain a unique PTAN for each provider under our PC group. Providers must electronically sign the application in PECOS when prompted via an email from CMS. Providers must complete their e-signature to finalize their enrollment. We explain how to e-sign here.
This enrollment does not affect any other Medicare enrollments your provider has with other groups (e.g., under your practice's own Tax ID), and does not require you to submit Traditional Medicare claims through Zaya. Providers already enrolled with Medicare can be linked to multiple medical groups at once. Enrolling with Zaya will not impact other affiliations.
Processing timeline
Zaya is a delegated entity with most insurance plans, meaning plans authorize us to perform credentialing and process enrollments on their behalf under agreed standards. Practically, this lets us credential and enroll providers much faster than typical carrier‑direct timelines.
Our part: We submit updates quickly once your form arrives.
Your part: You act quickly on any requested documentation or actions by our credentialing team
Insurance directories: Public listings are controlled by insurance plans and may take up to ~3 months to reflect changes, even when your enrollment is already active respectively a provider's termination already submitted.
Active enrollments (when you can bill)
On your Zaya Portal, under the 'Admin' section, it shows each insurance next to the provider, with in‑network status and an effective date. The status is updated live.
You can bill in‑network once the status says 'In-network' and the effective date is reached.
For any questions, our credentialing & enrollment team is here to help you - email credentialing@zayacare.com
Related: Credentialing providers through Zaya
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