Credentialing
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.
- NCQA and URAC aligned process
- Credentialing review begins after agreement execution
- Provider information is verified before committee review
- Complete documentation helps avoid delays
Required Documents
To support a smooth and efficient credentialing process, each provider is asked to submit the following documentation.
Credentialing Application
Completed credentialing application.
Attestation Page
Current signed attestation page dated within the last 45 days.
W-9 Form
Current W-9 form for provider records.
Malpractice Insurance
Current malpractice insurance documentation.
State License(s)
Current state license documentation.
DEA Certificate
Current DEA certificate, when applicable to the provider.
CDS/DPS Certificate
Current CDS/DPS certificate, if applicable.
Board Certification
Current board certification, if applicable.
Professional Education Completion
Certificate of completion for the highest level of professional education, if not board certified.