Practitioners’ rights during credentialing process

The credentialing process must be completed before a practitioner begins seeing members and enters into a contractual relationship with a health care insurer. As part of our credentialing process, practitioners have certain rights as briefly outlined below.

 

Practitioners can request to:

• Review information submitted to support their credentialing application.
• Correct erroneous information regarding a credentialing application.
• Be notified of the status of credentialing or recredentialing applications.

 

The Council for Affordable Quality Healthcare (CAQH®) universal credentialing process is used for all providers who contract with Anthem Blue Cross (Anthem). To apply for credentialing with Anthem, go to the CAQH website at https://www.caqh.org and select CAQH ProView™. There is no application fee.

 

We encourage practitioners to begin the credentialing process as soon as possible when new physicians join a practice. Doing so will help minimize any disruptions to the practice and members’ claims.