Credentialing Instructions

RPN accepts CAQH applications for all states or the state-specific application.

If your therapist is registered with CAQH, RPN accepts applications printed from CAQH with an attestation signature less than 60 days old. Please note we cannot accept the summary pages. Follow the CAQH print instructions below and fax to 919-878-8871.

The RPN signature page (Attestation Statement) also needs to be signed, dated and returned if you send in the CAQH application.
Please know the credentialing process can take up to 90 days. Providers should not see patients or submit claims until the credentialing process is complete as claims will deny if submitted before their approval date.

Applications may be returned via:

Email: [email protected]
Fax: 919-878-8871
Mail: RPN
Attn: Credentialing
3301 Benson Drive, Suite 135B
Raleigh, NC 27609

• Instructions to print CAQH application
• Attestation Signature Statement
• Credentialing checklist

State-specific applications

Please use the below links to print the state mandated applications.

• North Carolina Application
• Ohio Credentialing Application
• South Carolina Application
• Virginia Application

RPN application can be used for South Carolina and Virginia

• RPN Application