Provider Credentialing
To support Consumers Life’s mission to provide financing and management of health benefits that improve the health and well being of our members and the communities it serves, the Company credentials all providers applying to our Networks and periodically thereafter for the duration of the provider’s participation in those Networks.
- Council for Affordable Quality Healthcare (CAQH)
Clinical Credentialing supports
Consumers Life
has joined other health insurers who participate in the HIPAA compliant, one-stop credentialing application process developed by the Council for Affordable Quality Healthcare (CAQH).
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Credentialing Requirements
Consumers Lifecredentials providers according to the standards of nationally accrediting bodies, as well as Company policy and procedure.
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Clinical Credentialing
Clinical Credentialing conducts office site and medical record review, promotes compliance with national quality and regulatory standards, educates the provider community to the nationally recognized standards, develops and implements Corrective Action Plans and oversees the credentialing policies and procedures of delegated entities.
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Network Nomination
Network Provider Nomination & Enrollment Form.
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Provider Credentialing Rights
Providers are afforded certain rights in relation to the credentialing process, including the
right to be informed of the status of their credentialing application, the right to review
information submitted in support of their application, and the right to correct erroneous information.