Member eligibility renewals are happening. Members - find out what to do to keep your insurance.
Providers and their practitioners must be credentialed before they are considered part of our network. Credentialing is done in tandem with the contracting process.
These providers require facility/organization credentialing:
Allow 30-90 days for processing (a longer time is needed if a site visit is required).
You must submit:
To check the status of your credentialing application, email firstname.lastname@example.org. Please include your tax ID and NPI(s).
We conduct quality assessment site visits for provider location(s) that have not had an MDH or DHS site visit within the last 36 months, or who are not accredited through approved agencies as listed in the Provider Manual. We also conduct site visits for new locations opened under an existing contract where the provider policies have changed or new service were added.
In the event that a provider has satellite facilities which offer the same services and are held to the same policies, a site visit can be performed solely on the primary location.
For more information on site visits, refer to Section 18.15 in the Provider Manual.
A member of the Provider Operations team will contact you to confirm the update.
We require facility/organization recredentialing every 36 months. The recredential process AND Credentialing Committee approval must be completed by the last day of your due month in order to remain in good standing.
We notify facilities/organizations of recredentialing 180 days before their due date.