Practitioners’ rights during credentialing process
The credentialing process must be completed before a practitioner begins seeing Anthem HealthKeepers Plus 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 HealthKeepers, Inc. To apply for credentialing with HealthKeepers, Inc., 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.
* CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
December 2018 Anthem Provider Newsletter - Virginia