Before beginning the credentialing process, the first step is to let us know that you’d like to join our network – known as submitting a Request for Participation (RFP).
During the credentialing process, we’ll work with you to verify your qualifications, practice history, certifications and registration to practice in a health care field.
UnitedHealthcare’s credentialing standards fully comply with the National Committee on Quality Assurance (NCQA) as well as specific state and federal requirements.
Each facility must meet the following criteria to be considered for credentialing:
If you have questions about any of the required items, please review the UnitedHealthcare Credentialing and Recredentialing Plan for 2023-2025, specifically:
Completing a CAQH Provider Data Portal application is a fast and easy way to securely submit credentialing information. You enter information just once and it’s available to multiple health insurers at no cost to you.
Many states require that you complete a state-mandated credentialing application. In most cases, you can do this through CAQH – the information you submit will be converted into the appropriate state application format. To find out if your state requires its own application, review the UnitedHealthcare Credentialing Plan State and Federal Regulatory Addendum.
If you have a CAQH Provider ID number and are registered with CAQH Provider Data Portal, here’s what you need to do:
Here’s what you need to do:
Once we receive your completed application from CAQH, we’ll review your application and verify your credentials. Specifically:
To check the status of your credentialing application, Sign In with your One Healthcare ID. This allows you to access self-service tools or connect to a chat advocate for support.
Please have the care provider’s full name, Tax ID, and National Provider Identifier (NPI) available.