FAQs for Provider Credentialing

Community Health Options is accredited by the National Committee for Quality Assurance (NCQA) and is required to follow their Credentialing Standards as well as any state applicable laws

For a list of provider types that require credentialing, please see our Credentialing Policy.

CHO utilizes the CAQH (https://proview.caqh.org/Login) application as its credentialing application.

Initial data entry into our provider system begins in the Data Integrity Department, their initial data entry requires at least 30 days to be completed and then the Credentialing department is notified of the new applicant.

Once received from the Data Integrity Department, the credentialing process typically takes up to 60 business days to finalize. This timeline applies only to the credentialing cycle.

Once credentialing is approved, an email Welcome Letter will be sent to your practice’s designated credentialing contact. This welcome letter will include your practice participation date as well as the practitioner’s credentialing date.

We use a third-party Credentialing Verification Organization (CVO) called Verisys or the Community Health Options Credentialing team will reach out to the credentialing contact on file if any information is missing.  

After 60 days from the Provider Network Form submission date, you can check your credentialing status by contacting the Community Health Options Credentialing department via email. 

Per policy, Community Health Options is required to re-credential providers every three (3) years. This process will start approximately 3 months before the due date.

We encourage providers to wait until the credentialing process is complete and they have received their welcome email before seeing patients. If you need to provide service to a member before the effective date, please contact the Community Health Options Contracting Department.