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Practitioner Credentialing Application Packet - Providers

Practitioner Credentialing Application Packet - Providers 2025

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The document is a comprehensive credentialing application for healthcare providers seeking to participate in AlohaCare's QUEST Integration Health Plan in Hawaii. It outlines the necessary forms, required documents, and important information regarding the enrollment process with the State of Hawaii's Department of Human Services. The application includes sections for personal information, professional qualifications, board certifications, licensure details, and compliance with nondiscrimination laws. It emphasizes the importance of complete and accurate submissions to avoid delays or rejections in the credentialing process.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How much does provider credentialing cost?

On average, the cost of physician credentialing is approximately $2,000-$3,000 per year. Heres a breakdown of the costs associated with individual pieces of the credentialing process: Individual physician credentialing costs between $100-$200 per physician.

Which form of professional credentialing is considered the most restrictive?

Licensure tends to be the most restrictive form of professional regulation; it often is referred to as right-to-practice.

What insurance companies are best to get credentialed with?

First, there are a number of major insurance companies that cover 10s of millions of lives across the USA. These are generally a good choice to get credentialed with. These include: Blue Cross, Blue Shield, Aetna, Cigna, Tri-Care, Medicare, Value Options, Humana, United Health Careand about 10 others.

What are the three types of credentialing?

What is an Example of Credentialing? Professional Credentialing. Facility Credentialing. Payer Enrollment Credentialing.

What are the two types of credentialing?

Types of credentialing Personal Credentialing. Political Credentialing. Paperless Credentialing.

What is the credentialing process in healthcare?

Credentialing is a vital process for healthcare institutions. In simple terms, it is the process of assessing a healthcare providers academic qualifications and clinical practice history.

What comes first credentialing or privileging?

Hospitals and other health care employers and payers both have credentialing processes to complete. Credentialing is closely tied with privileging and is frequently a first step for physicians seeking hospital privileges.

Who does provider credentialing?

The provider credentialing process is completed in stages by a provider organizations or payers credentialing department, or an internal or third-party CVO. Credentialing staff: Gather information from many sources, including the providera step that often includes significant follow-up efforts.

Practitioner Credentialing Application Packet - Providers 2025

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