Credentialing
Building a Strong Provider Network
Building a reliable health plan network begins with credentialing—a critical process that ensures every provider meets rigorous standards for quality, compliance, and patient safety. Credentialing verifies licenses, certifications, education, and professional history, giving members confidence in the care they receive.
Why Credentialing Matters
- Protects Patients: Ensures providers are qualified and meet regulatory requirements.
- Maintains Compliance: Aligns with state, federal, and accreditation standards.
- Builds Trust: Strengthens our network’s reputation for quality and reliability.
- Expands Access: Adding providers efficiently allows members to have timely access to care.
Our Credentialing Process
Chorus Community Health Plans (CCHP) recredentials licensed individual practitioners (LIPs) at least every 36 months from the month of the previous credentialing decision.
If the LIP is on active military duty, maternity leave or sabbatical, the recredentialing cycle is extended by the Credentialing Committee and documentation is placed in the practitioner’s credentialing file. Upon return to practice, the LIP is recredentialed within 60 calendar days.
An LIP or organizational provider must not have had prior denials or terminations, and must not have been denied participation (for reasons other than network need) by CCHP within the preceding 24 months.
When network participants are terminated due to actions on their license, an application for credentialing cannot be accepted for 24 months after termination.
CVO Partner
To ensure the highest quality of care and efficient processing, Chorus partners with a Credentialing Verification Organization (CVO), Symplr Payer. This partnership allows us to streamline the credentialing process, performing thorough and timely primary source verifications of practitioner credentials such as licenses, education, and certifications. Providers may interact directly with Symplr Payer for credentialing applications and verifications, while Chorus maintains responsibility for final credentialing decisions and network participation.
Symplr Payer is an NCQA certified CVO. Achieving CVO certification from NCQA demonstrates that Symplr Payer has the systems, process and personnel in place to thoroughly and accurately verify providers' credentials and help health plan clients meet their accreditation goals.
Interested?
Would you like to join the CCHP provider network? Find out more information on becoming a CCHP provider.