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Practitioner Credentialing
Please note that as a practitioner, you have the right to:
- review information submitted to support your credentialing application,
- correct erroneous information, and
- be informed of the status of your credentialing or recredentialing application upon request.
Recredentialing Process
Below is an outline of our recredentialing process, along with Care Choices and provider responsibilities.
Care Choices /
Preferred Choices Responsibility |
Provider Responsibility |
| Send initial written request to provider with:
Recredentialing form
List of required documentation |
Complete recredentialing form and submit required documentation within 30 days of receipt of the letter. |
| If provider does not submit information within 30 days |
| Send second written request to provider with:
Recredentialing form
List of required documentation |
Complete recredentialing form and submit required documentation within 10 daysof receipt of the letter. |
| If provider does not submit information within 10 days of second request |
| Send third written request to provider with:
Recredentialing form
List of required documentation |
Complete recredentialing form and submit required documentation within 10 daysof receipt of the letter.
Note: If provider does not respond to the third written request within 10 days of receipt of the letter, it will be assumed that the provider no longer wants to participate with Care Choices HMO and will be terminated. |
| After provider information is received by Care Choices |
Verify State/Federal licensure status and hospital affiliation status. Query the National Practitioner Data Bank and Healthcare Integrity and Protection Databank. Results of continued participation status will be communicated to the provider upon completion. |
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