Humana Provider Credentialing Services
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Our Credentialing Process Review
Humana requires the use of ProView from the Council for Affordable Quality Healthcare (CAQH), a technology that allows you to securely submit credentialing information to many plans and networks by entering data only once. Data for applications can be submitted at any moment using the internet. This shortened credentialing procedure saves time and reduces paperwork. It’s completely free.
For CAQH ProView, doctors and other healthcare professionals are not required to use Council. They should check with their state medical board to see if the credentialing requirements that apply to them are correct.
You must have an up-to-date and fully completed CAQH ProView application to become certified for the first time. Could you please make certain that you?
Complete all of the fields on the form now that are
- List all prior and current practice locations
- Include numbers like the physicians or provider’s Social Security number, National Provider Identifier (NPI), Drug Enforcement Administration number, unique provider ID, and professional licensing numbers.
- Provide answers to all inquiries and, if necessary, explanations
- Don’t forget to include the attestation form, which needs to be signed and dated
Submit digital copies of your work to get credentialing fast
- A month/year employment history
- A DEA certificate or a professional license is required
- Controlled Dangerous Substances Certificate (CDS)
- A copy of the malpractice insurance front sheet
- A list of malpractice cases that are currently pending or have already been resolved
- Please give Humana permission to access the CAQH ProView request
Requirements: Need to Fulfill
- The applicant must be in good shape with state and federal regulator record
- The applicant supplier must be evaluated and approved by a competent organizationEvery three years, the state and federal regulatory authorities are re-evaluated and approved by an authorized authority
- Continue to pay for liability insurance
- A copy of the facility’s state license
- CLIA credentials are up to date
- The application must be signed and dated
As previously indicated, Humana’s insurance policy covers at least 13 million Americans. As a result, a human health insurance provider’s permission to network with people in a profitable industry is valid. Because there are so many moving elements, the procedure is exceedingly time-consuming. Thankfully, our team is on hand to assist you throughout the procedure.
How to go for Applying? Pre-Application
Send in your application today
When a practitioner meets Humana’s Health Insurance Credentialing criteria, they receive an email with an application packet containing all of the necessary information to get started. Humana will continue to have access to application expertise on the CAQH (Council for Affordable Quality Healthcare) with the approval of the parties involved (CAQH).
The applicant must submit the following application information, based on
- A certificate from the Drug Enforcement Administration of the State
- A license that is both active and unrestricted (If Applicable)
- Eligibility for Medicare and Medicaid, as well as the Medicaid number
- In-hospital participation with Humana clinical privileges
- Humana Board Certification Insurance Credentialing Letter of Interest
- Education and professional development
- Work experience of five years
- History of Malpractice Claims Adequate Malpractice Insurance
Continuation
How we connect with you after Successful Credentialing
Application verification has been approved.
Any documents or job information that is missing will be demanded. Humana will notify the user that the application has been abandoned if any important documents or information are identified to have been missed during the process. Constant updates on the status of an application, including any obstructions you may encounter at any time.
Acceptance of Humana
If a practitioner’s application is approved by Humana, the practitioner joins Humana’s network of providers. Humana will update the provider information in their database during the following ten business days.
Although time-consuming, being a Humana in-network provider is necessary for providers to gain insured clients through the Humana Insurance program. We understand that doctors would rather spend their time treating patients than going through the time-consuming process of credentialing. As a result, we provide a comprehensive end-to-end credentialing solution that will guide you through the entire procedure.
Re-Contracting
Once the items are complete, a Physician Contracting Representative will contact your office to schedule a time to collect the credentialing documents and conduct a site visit review, ensuring that all necessary documentation is completed for submission to the review committee. You must provide credentials every year if you are currently a participating supplier. Every three (3) years, Humana requires clinicians to re-credential.
Phone number for Humana Credentialing
Reach out to us with any suggestions or comments on maintaining ethical behavior or identifying and preventing fraudulent or criminal misbehavior should contact the Ethics Office or call the Helpline at 1-877-5- (1-877-584-3539).
Enrollment Application for Humana
You’ll be engaged to apply online with all of your established credentials at Humana. Every single entity you enter will be verified and cross-checked by them. It has a number of pre-requisite identifying choices to help you mark and show your legitimacy. This way, they’ll double-check all of your information and keep you updated on your current procedures and progress.
Enrollment Email from Humana
Email: info@starspmb.com
FAQ! NEED HELP?
Humana Provider Enrollment is the process through which healthcare providers apply to
become part of Humana's network to deliver healthcare services to Humana members in the
USA.
Providers can start the enrollment process by visiting the Humana provider portal or contacting
Humana directly to obtain the necessary enrollment application forms. At Stars Pro we have an
expert Humana credentialing team, our credentialing specialists will enroll you with Humana in
minimum time.
Required documents may include professional licenses, liability insurance certificates, W-9
forms, and tax identification numbers, among other specific credentials. Stars Pro credentialing
team will securely submit these documents to Humna to enroll you accurately and on time.
The time required for enrollment can vary, but it generally takes several weeks to several
months. Providers are encouraged to start the process well in advance. Our medical
credentialing specialist enroll healthcare specialists with Humana within minimum time.
If an application is denied, Humana will typically provide the reasons for the denial. Providers
may have the opportunity to appeal the decision or reapply after addressing the issues. Our
credentialing team will contact the Humna enrollment team, identifies the denied reasons and
after correcting errors resubmit the application for the enrollment process.
Yes, enrolled providers are often required to meet ongoing compliance and credentialing
requirements to maintain their status in the Humana network.
Providers can access the most up-to-date information and resources on the Humana provider
portal, if you need assistant Stars Pro credentialing specialists as will directly communicate with
Humana representative to solve your credentialing problems.
Recredentialing is typically required every three years. The process is similar to the initial
enrollment and involves updating and verifying provider information and qualifications. We will
complete the recredentialing process on priority basis without any delay.
Channel Partners
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