Keystone First VIP Choice (HMO SNP) re-credentials network practitioners at least every three years. All practitioners involved in the re-credentialing cycle are sent a re-credentialing notification letter three to six months prior to the re-credentialing due date. The following information is needed in order to complete the re-credentialing process:
- Application – Credentials update form or CAQH universal provider data source.
- Practitioner CAQH reference number.
- Office hours/service addresses.
- Supporting documents – State professional license, Federal DEA registration, state controlled substance certificate, malpractice face sheet, CLIA certificate (if applicable).
As with initial credentialing, all applications and attestation/release forms must be signed and dated no more than 180 days prior to the Credentialing Committee decision date. Additionally, all supporting documents must be current at the time of the decision date.