UnitedHealthcare Credentialing Plan updates

Last modified: July 17, 2023

Updated to remove a link to an expired document

Summary of changes for 2023–2025 effective March 1, 2023

UnitedHealthcare reviews and updates our Credentialing Plan at least every 2 years to maintain compliance with all state and federal regulatory requirements, as well as accreditation requirements of the National Committee for Quality Assurance (NCQA). With that in mind, we have made several changes to the UnitedHealthcare Credentialing Plan for the 2023-2025 time period. The 2023–2025 UnitedHealthcare Credentialing Plan will be effective March 1, 2023.

Important changes for the 2023-2025 period include:

Updated definitions of the Regional Peer Review Committee
Updated the name of the patient safety policy to “Government Agency Investigation Monitoring Involving Potential Imminent Threat to Patient Safety Policy”
Added oversight of credentialing system controls to the Delegation Credentialing Section
Added a note that a delegated licensed independent practitioner or facility could be terminated if they have a loss of license or material restriction