CareSource Credentialing Services

Our Mission

To invest in programmes and organizations that make a long-term difference in the lives and communities of our members by increasing their health and well-being.

Our Vision

Changing people’s lives through innovative health and life services.

Values Statement

The Foundation supports individuals, organizations, and programmes that actively endeavor to improve the physical and mental health and well-being of persons living in our service areas. We think that passion, knowledge, and vision result in constructive, long-term change, and that genuine cooperation results in great partnerships with grantees.

How to Join Our Network?

If you offer medical services and want more information about becoming a participating provider, please submit the following information when completing the New Health Partner Contract Form.

  • Your W-9 tax form
  • Name
  • Specialty
  • CAQH ID number
  • Tax ID number
  • NPI number

Get Credentialed                         

Credentialing is required for providers that want to work with CareSource. We check the credentials and performance of physicians and other health care practitioners through credentialing. Providers are re-credentialed at least every three years and are presumed to be so unless otherwise notified.

Process of Contracting and Re-Credentialing

Care Source’s policy is to ensure the quality and qualifications of professionally licensed practitioners and organizational providers by credentialing and re-credentialing in accordance with regulatory and accreditation criteria. The credentialing and re-credentialing programme is overseen by our Vice President/Senior Medical Director.

To CareSource, you must submit a complete Council for Affordable Quality Healthcare (CAQH) application or your CAQH number and National Provider Identifier (NPI).

You’re Application

We are a CAQH participant organization. Before submitting your CAQH number, please ensure that we have access to your provider application:

  • Log in with your account details to CAQH
  • Choose the Authorization tab
  • Check to see if CareSource is recognized as an approved health plan
  • If not, add by checking the Authorized box

CareSource Provider Enrollment

Provider enrollment is the process of adding a contracted and credentialed provider to all of Care Source’s internal systems, including loading for claims payment and adding the provider to the provider directory (if applicable). Enrollment in a provider does not occur until the provider has been properly approved and accredited.

CareSource strives to load your information into our internal systems after a provider completes the contracting and credentialing process. Before you may be deemed a CareSource participating provider, you must complete the entire provider enrollment procedure.

Letter of Welcome

After you have completed the enrollment procedure and your provider information has been entered into the CareSource system and Provider Directory CareSource will send you a welcome letter within five business days. Important information will be included in your CareSource Welcome Letter, such as:

  • Enrolled Products on the Network as of the Effective Date
  • CareSource Provider Number
  • Additional instructions for submitting claims
  • Getting in Touch

Check Your Status

CareSource allows you to verify the status of your application and credentialing on the Provider Portal by completing the procedures below:

  • Navigate to Login > Provider
  • Just choose right state
  • Click the Check Enrollment Status button
  • Enter your NPI as well as your Application ID

In addition to specific credentialing documents, the tool will allow you to review your status in the credentialing process.

Please Contact Us

Do you require assistance? If you have any additional general questions about being a CareSource provider, please contact Stars Pro Credentialing Specialist   1-732-523-4633.