Credentialing

Provider Network

Provider Credentialing

Prime Health Services, Inc. is committed to maintaining a fully credentialed provider network by adhering to NCQA and URAC guidelines. Once a provider participation agreement is established, we begin the credentialing process by verifying key provider information and submitting it to our Credentialing Committee for review.

Quick Overview
  • NCQA and URAC aligned process
  • Credentialing review begins after agreement execution
  • Provider information is verified before committee review
  • Complete documentation helps avoid delays
Checklist

Required Documents

To support a smooth and efficient credentialing process, each provider is asked to submit the following documentation.

01

Credentialing Application

Completed credentialing application.

03

W-9 Form

Current W-9 form for provider records.

04

Malpractice Insurance

Current malpractice insurance documentation.

05

State License(s)

Current state license documentation.

06

DEA Certificate

Current DEA certificate, when applicable to the provider.

07

CDS/DPS Certificate

Current CDS/DPS certificate, if applicable.

08

Board Certification

Current board certification, if applicable.

09

Professional Education Completion

Certificate of completion for the highest level of professional education, if not board certified.