We’re glad to hear that you are interested in joining our network. We have a diverse network of exceptional health care professionals that ensure our members have uninterrupted access to the health care they need.
You make your patients' lives better. We'll do the same for you.
Our prior authorization, referrals, claims and payment processes are streamlined to help you focus on what you do best — caring for your patients.
Credentialing is the process we use to evaluate and select licensed independent practitioners to provide care to our members.
We use the Council for Affordable Quality Healthcare (CAQH) ProView®* application for credentialing. This secure and private portal reduces the amount of paperwork you need to fill out to complete the credentialing process.
Why do we credential?
Credentials are evaluated according to criteria set forth in our policy to ensure the competency and conduct of the health care professionals serving members in our network.
Whom do we credential?
We credential licensed health care professionals with whom the company intends to contract and market to our members. The Provider Manual includes a complete list of provider types we credential and those we do not.
If you need assistance, call the CAQH Provider help line at 1-888-599-1771.
A complete application includes:
The credentialing process typically takes 45 days from the time the Credentialing department receives your completed CAQH application.
We recredential network providers every three years. If your CAQH application is current and complete at that time, no additional effort on your part may be required. If CAQH is expired or missing information, we will contact you to update the information.
Non-response to recredentialing requests
If you do not update CAQH or supply the required information for recredentialing by the due date, your application will be considered incomplete and will result in an administrative termination from the network.
Providers have the right to:
To review your application or correct submitted information, please call our Credentialing team at 1-844-421-5662.