2/4/2016

The primary cause for delays in the credentialing process is when provider credentialing applications are submitted with missing or incomplete information. The Midlands Choice credentialing department shared the following guidelines to help ensure that credentialing applications are processed in a timely manner:

  • All portions of the application must be complete, accurate and legible. Attaching the provider's curriculum vitae to the application does not serve as a substitute for completing all sections of the credentialing application.

  • Submit all supporting documentation with the credentialing application. Provide copies of the provider's license, controlled substance certificate and malpractice insurance certificate. These documents are used to validate information found on the credentialing application.

  • If there is a "yes" response to any question listed on the credentialing application, a typed explanation must accompany the application. This information is reviewed by the Midlands Choice credentialing coordinators, medical director and credentials committee members and may be crucial in the approval process.

  • The provider being credentialed must review and approve all information listed on the application. Any discrepancies found during the credentialing process may lead to processing delay or even the rejection of the application.

  • Submit only one completed application for each provider. Midlands Choice accepts the Midlands Choice provider application or any state universal application. There is no need to submit multiple applications in different formats.