United Healthcare Credentialing Services for your Independent Practice

Join a community of doctors, medical professionals, and organizations who share our mission to helping customers in living healthier lives and improving the healthcare for all.

Our Specialist Team will help you to Get Credentialed Now!

We will go along with you to review your educations, training history, certificates, and registration to practice in a health care area during the credentialing process.

What’s you have to provide for Credentialing to Our team

United-Healthcare’s credentialing standards are fully submissive with the National Committee on Quality Assurance [NCQA] as well as state and federal laws.

Requirement

Training & Schooling
• Post-graduate education or practice, as well as a practitioner degree [MD/DO/DPM].

• Information on medical or professional education and training

• Fulfillment of a residency plan in the preferred specialty

Authorizing and Certification
• Current permit or certification in the country in which the care provider will be practicing

• National Provider Identification [NPI] no.

• DEA no./ CDS document

• Medicare certification

Previous Employment Details
• 5-year work history

• Description of work conditions, license account and permissions

• [W-9] report

• Hospital staff prerogatives

Insurance
• Active negligence insurance or a government alternatives

• History of misconduct

To be eligible for credentials, every facility should meet specific criteria:
• Current necessary license(s)

• General/full liability insurance

• Errors and imperfections (negligence) insurance

• Proof of Medicare/Medicaid plan participation qualification

• Proper accreditation by a recognized firm, or satisfying alternative, Centers for Medicare & Medicaid Services (CMS) certification.

How to complete a Credentialing Application

Submitting a CAQH-Proview form is a simple and effective way to provide credential confidential information. You only need to enter information once, and it will be accessible to multiple insurance companies at no cost to yourself.

If you seek a Medicare or business plan, or a combination of Medicare, Medicaid and commercial, you will start the credentialing process by working with us.If you are only seeking a Medicaid (Community) program, please watch the guidelines.You will begin the credentialing process by registering with our Provider Source.For all others, you can directly contact us immediately now.

Already fulfilled a CAQH form?

If you own a CAQH-Provider-ID no. and are listed with CAQ-ProView, here’s what you need to do

• Verify to make particular the account is up to date and perfect. Your request will not be delivered to United-Healthcare until CAQH confirms that your application is excellent.

• Allow UnitedHealth care to locate your confidential data [either by picking global support or manually allowing UnitedHealth care].

 

How to complete the CAQH form?

Here’s what you need to do
• Continue to CAQH.org to create an account and finish an application.

• If you don’t fully perform the application or necessitate more information, someone from CAQH will communicate with you.

• Please reply to any inquiries from CAQH promptly so that you can finish your application promptly.

• CAQH will inform you when your request is concluded.

What comes subsequently?

CAQH will give you a periodic notice to check and amend your data; maintaining your current form makes it so much easier to authenticate with other insurance and accelerates the credentialing procedure.

Approve your credential

We will assess your request and validate your credentials after we get your certificate of completion from CAQH. Especiallywe will approach the state licensing board for your license and check your educational practice, among other things. Aperture performs this primary source assessment on the direction of UnitedHealthcare.A panel of your counterparts processes your request to see if you meet the credentialing standards of UnitedHealthcare. This peer-review process could add roughly 20-25 days from the date.

Assess your position.

Write an email to networkhelp@uhc.com to inquire about the progress of your credentials request. Kindly include the entire name, tax ID, and National Provider Identifier of the caregiver (NPI) in when you write an email to them.

Get contracted too.

Contracting is an independent procedure from credentials; however, we will begin the contracting operations with you when you are working through credentialing to keep things going.

Re-credentialing

After three years in the program, you will be notified for credentialing to guarantee your certifications stay in effect and relevant. Your specialty-specific instructions will be included in the notification.If your application is current and on CAQH ProView-TM, you may not have to perform any action due to re-credentialing.CAQH ProView allows you to submit modifications to your services or service areas at any time.

Once United Health care receives all necessary relevant documents, your provider’s re-credentialing form will be completed within five business days.Write an email to networkhelp@uhc.com to inquire about the progress of your credential application. Kindly provide the full name, tax ID, and National Provider Identifier of the care provider (NPI).

Re-credentialing enables you to modify the practice premises and contact details that we use with the Provider Directory that patients can access.National accrediting organizations, as well as state and federal regulatory authorities, establish credentialing criteria. United Health care’s credentialing standards are fully compliant with the National Committee on Quality Assurance (NCQA) as well as state and federal regulations.