Update to 2019–2021 Credentialing Plan

Effective June 1, 2020, the following updates have been made to our 2019–2021 Credentialing Plan. Credentialing requirements for facilities include either accreditation or a site visit.

The following considerations have been added to address the site visit:

  • A site visit is not required if the facility is in a rural area, as defined by the U.S. Census Bureau, and the state or CMS has not conducted a site review.
  • If a facility has satellite facilities that follow the same policies and procedures as the provider, the organization may limit site visits to a main facility.
  • If a CMS Institutional Provider/Facility type is not located in a rural area and is not CMS certified, then you may complete a self-assessment using UnitedHealthcare's Facility Site Visit tool provided by the National Credentialing Center. 
    CMS Institutional Provider/Facility Includes:
    • Hospice
    • Clinical laboratories
    • Comprehensive outpatient rehabilitation facilities (CORF)
    • Outpatient physical therapy providers
    • Speech pathology providers
    • End-stage renal disease services providers
    • Outpatient diabetes self-management training providers
    • Portable X-ray suppliers
    • Rural health clinics (RHC)
    • Federally qualified health centers (FQHC)

You can find more information by visiting UnitedHealthcare Credentialing Plan or visit UHCprovider.com >Menu > Resource Library > Join Our Network > Get Credentialed.