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 2019-2021, specifically:
Completing a CAQH ProView 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 ProView, 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:
You can check on the status of your credentialing application by calling our automated system at UnitedHealthcare at 877-842-3210. Enter your Tax ID Number (TIN), then select Other Professional Services > Credentialing > Medical > Get Status or send an email request to firstname.lastname@example.org. Please include the care provider’s full name, tax ID, and National Provider Identifier (NPI).