Credentialing Process
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.
If an LIP has been terminated for administrative reasons and not for quality reasons, and the LIP is reinstated within 30 days, initial credentialing is not required. If reinstatement is more than 30 calendar days after termination, initial credentialing is performed.
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.
Helpful Links
Below are some additional helpful resources to help with provider changes and notifications.