Certifyos Arvostelua 2

I cannot be more upset with this company. They wasted SO much of my time and money. I literally learned credentialing myself because of them.

They were contracted with the EMR company I was using and trusted. Services were not provided by Certify and that have literally cost me THOUSANDS of dollars in missed revenue. I knew credentialing would be tedious and long, so I started months (July) before we were set to open. I was not prepared for the lack of communication and execution by Certify because of their close affiliation with the EMR company I was using. I opened my clinic in September anticipating credentialing would be completed shortly after, but since September, my clinic has been open without insurance payers and a "live" EMR because of Certify's incompetence. It is January.

I put in credentialing requests to Certify on 7/1/2025 for:
Aetna Commercial/Medicare/Medicaid
Ambetter Commercial/Medicare/Medicaid
Humana Commercial/Medicare/Medicaid
UnitedHealthcare Commercial/Medicare/Medicaid
Blue Cross Blue Shield Commercial/Medicare/Medicaid
Louisiana Healthcare Connections Commercial/Medicare/Medicaid
Medicaid Commercial/Medicare/Medicaid
Medicare Commercial/Medicare/Medicaid

I was invoiced for >$3200.00

The ONLY payer I am credentialed with is Aetna Commercial and Medicare. When I inquired with Aetna, I was told I still had to apply for Aetna Medicaid myself even though on the Certify portal it states Aetna "Commercial/Medicare/Medicaid" is in "Effective" status. So I applied with Aetna Medicaid myself.

I called Ambetter and they do not have an application on file and have not heard of my TIN/Type 2 NPI. I submitted my own network participation request to Ambetter.

On November 13th, I signed an MCD Agreement contract for Humana Medicaid that was started by Certify, but when I inquired with Humana, I was told that it was just for Medicaid. Humana Commercial or Medicare did not have an application on file, so I applied for Humana Commercial and Medicare on my own. Humana Medicare stated they were at capacity for PCPs.
Humana Commercial/Medicare/Medicaid had been changed to "Submitted" status 8/21/2025 in Certify Portal.

UnitedHealth Care was started by Certify but when I inquired with UHC why they did not have my TIN on file, they stated I need to submit an "out of network" claim first so they will recognize my TIN. I went ahead and submitted a separate request for AmeriHealth Caritas Medicaid myself because who knows if Certify did. Its January now and apparently Certify applied for me as an out of network provider so I still had to apply again. Almost 6 months later.

BlueCross Blue Shield was started by Certify but not finished and I could not get them to reply to me on the portal re: a docusign that is on my task list but has apparently expired so I can not complete. This application is not in "submitted" status because of "missing information" and it took weeks to get someone to reply to me what/why it was still in "missing information" status. It is now January and I am starting the process over myself because Certify had my clinic as an Allied Health Professional versus Advanced Practice Provider.

Louisiana HealthCare Connections also did not have my TIN/Type 2 NPI in their system so I was told to submit a request myself. I submitted my own network participation request to Louisiana HealthCare Connections myself, which took hours.

I finished the application for traditional Medicaid myself. Medicaid was initiated by Certify but it was missing at least 10 important items, so the whole original packet was mailed back to me in the beginning of November to complete. When I told Certify and asked them what I should do, I was told they were only handling new applications at the moment because of the wind down with my EMR (they were fired) and would get back to me the following week. They did not get back in touch with me. So I called Medicaid myself and asked the questions Certify never answered, completed the packet myself, and mailed it back.

Medicare was initiated originally by Certify and they came to do a site visit end of August, before the clinic was open so we were denied. You cannot resubmit for 65 days so I will resubmit to Medicare myself.

I can not warn you enough to NOT use this company.

Avoid at all costs

CertifyOs has been an absolute disaster and one of the worst business decisions I’ve made.

They failed to submit my AHCCCS application entirely, despite being contracted to do so. This was not a delay or processing issue—the application was simply never submitted. In addition, they never followed up on TriCare or TriCare for Life, leaving my credentialing incomplete for months.

Communication is abysmal. It routinely took over 30 days to receive responses to basic questions through their own portal, making it impossible to correct issues in a timely manner. There was no proactive outreach, no accountability, and no urgency—despite the fact that provider credentialing directly impacts patient care and revenue.

As a result of their negligence, I lost thousands of dollars in revenue, experienced unnecessary delays in seeing patients, and ultimately had to spend additional time and money fixing problems that should never have occurred.

This was not a one-off mistake—it was a pattern of inattention, poor follow-through, and lack of professional responsibility. If you are a provider considering outsourcing credentialing, learn from my experience and look elsewhere. CertifyOs is not reliable, and the financial risk is simply not worth it.