Independence requires credentialing of physicians and all other types of health care providers who provide services to Independence members and who are permitted to practice independently under applicable state law. Providers must be credentialed and contracted before they are allowed to provide care to Independence members.*
Information on our network credentialing process and credentialing criteria can be found on our Professional Provider Credentialing webpage or in the Quality Management section of the Provider Manual for Participating Professional Providers.
Submitting credentialing applications
To ensure that credentialing applications are managed in a timely manner, it is important for providers to adhere to the processes outlined below for provider credentialing.
All professional providers interested in becoming a participating provider must apply for credentialing by completing the Practitioner Participation Form.
To become credentialed in Pennsylvania, providers are also
required to complete the Council for Affordable Quality Healthcare’s (CAQH) online credentialing application: CAQH ProView®.
If your practice contracts with multiple health plans, the CAQH ProView online application minimizes the administrative work needed to fill out multiple, redundant, and time-consuming forms.
If you have already been credentialed by Independence, there is no need to resubmit a
Practitioner Participation Form or a CAQH ProView credentialing application.
Important credentialing notes:
- Any professional provider interested in participating in our network
must complete the Practitioner Participation Form and the CAQH ProView credentialing application.
- Any credentialing application request
not received through the
Practitioner Participation Form
will be returned with instructions to submit the request using the form.
- The
Practitioner Participation Form is only for credentialing applications.
Submitting requests not related to credentialing
The
Practitioner Participation Form is used strictly for credentialing applications. If you need to make changes to your basic provider information (e.g., updating names, addresses, office hours, contact information associated with your practice), please use our
Demographic Maintenance Guide.
Learn more
If you have additional questions on the content of this article, please email our Provider Communications team at
provider_communications@ibx.com.
*Behavioral health providers must be credentialed by and contracted with Magellan Healthcare, Inc., an independent company. Interested behavioral health providers can contact Magellan by selecting the “Join the Network” link or by contacting their Magellan Provider Services Line at
1-800-788-4005 for assistance.
Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most Independence members.