Credentialing

Practitioner Credentialing

Practitioners must complete the practitioner contract application and approval process prior to credentialing with University of Utah Health Plans. Once credentialed, providers may begin to see members.

Initial credentialing and subsequent re-credentialing every three (3) years is required for all physicians and other types of health care professionals practicing under their own license as permitted by state law with whom members schedule appointments. The credentialing program follows the standards set forth by the National Committee for Quality Assurance (NCQA) and uses CAQH exclusively for the credentialing application.

University of Utah Health Plans requires that Advanced Practice Professionals (APP), including PAs, complete credentialing.

Where to Start? Let’s Get Started!

For new practitioners with your practice, simply send the following information for each practitioner to be credentialed, or a roster containing the information below, to our credentialing team at provider.credentialing@hsc.utah.edu.

  • Practitioner’s first and last names with middle initial

  • Practitioner’s title

  • Practitioner’s specialty

  • Practitioner’s date of birth

  • Practitioner’s CAQH Provider ID

  • Provider NPI

  • Group Tax ID

  • Primary practice location

  • Credentialing contact name and email address

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Mountain Health CO-OP does not discriminate based on race, color, national origin, disability, age, sex, gender, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

 

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