Authorize UnitedHealthcare to access your data (either by selecting global authorization or manually authorizing UnitedHealthcare).Your application will not be released to UnitedHealthcare until CAQH verifies that your application is complete. Check to make sure the account is up to date and complete.If you have a CAQH Provider ID number and are registered with CAQH ProView, here’s what you need to do: If you have any questions on accessing the CAQH ProView database, just call the CAQH Help Desk at 88 for assistance. For all others: You can start the process at.For providers in Washington: You will begin the credentialing process by registering with OneHealthPort ProviderSource.For providers in Minnesota: You can complete a credentialing application through either CAQH ProView or through the Minnesota Credentialing Collaborative.If you are only joining a Medicaid (Community) plan, please follow the instructions detailed under "For all others" below. For providers in Hawaii: If you are joining a Medicare or commercial plan, or a combination of Medicare, Medicaid and commercial, you will begin the credentialing process by working with MDW Hawaii.You enter information just once and it’s available to multiple health insurers at no cost to you. State-specific Credentialing and Recredentialing information on how to join the UnitedHealthcare Community Plan network can be found in the Care Provider Manual.Ĭompleting a CAQH ProView application is a fast and easy way to securely submit credentialing information.Passing score on state site visit (if required)Ĭredentialing For Medicaid and State Programs (Community Plan).Notification if this provider has ever been a delegated provider prior to this credentialing application.Other Credentialing requirements such as AMA profile or criminal history review as required by Credentialing Authorities.Active errors and omissions (malpractice) insurance or a state-approved alternative.History of loss or limitation of privileges or disciplinary activity.History of loss of license and/or felony convictions and.Any limitations in ability to perform the functions of the position, with or without accommodation.Statement of work limitations, license history and sanctions (only required if you are applying to join UnitedHealthcare’s Medicare and Medicaid plans).If there are any gaps longer than six months, please explain.Medicare/Medicaid participation eligibility or certification (if applicable).Active Drug Enforcement Agency (DEA) number and/or Controlled Dangerous Substance (CDS) Certificate or acceptable substitute (if required).National Provider Identification (NPI) number.Current license or certification in the state(s) in which the care provider will be practicing (no temporary licenses).Completion of residency program in the designated specialty.Details of medical or professional education and training.Practitioner degree (MD, DO, DPM), post-graduate education or training.Licensed Independent Practitioners - Credentialing Requirements Training and Education UnitedHealthcare’s credentialing standards fully comply with the National Committee on Quality Assurance (NCQA) as well as specific state and federal requirements.
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