United Healthcare Provider Credentialing

UnitedHealthcare is one of the largest health insurance providers in the United States. It offers health policies to employers as well as to individuals, and it underwrites policies offered by the American Association of Retired People (AARP) and other organizations that offer group coverage. A physician or other healthcare provider who practices alone or in a group practice can attract more patients by joining the UnitedHealthcare network as a provider, and the network offers incentives to practitioners who exhibit excellence in caring for its patients. A practitioner must verify his credentials before entering into a contract with UnitedHealthcare. The process is known as United Healthcare Provider Credentialing.

The following list provides a guide to United Healthcare Provider Enrollment:

1.  Ensure your credentials and licenses as a healthcare provider are up to date and that you meet all requirements for practicing your healthcare profession in your state. Have all of your credential information and license numbers ready for verification process.

2. Launch the UnitedHealthcare website and click "Physicians" on the top menu. Select "Join our network."

Note that although the prompt on the UnitedHealthcare site refers to physicians, the process is the same for all licensed healthcare providers, including dentists, chiropractors and physical therapists, who are in private or group practice and receive direct payments from health insurers. The United Healthcare credentialing application is the same for all.

3. Review the information on the "Join our network" page and call the "National credentialing center" number listed toward the end of the page.

4. At this point you enter your Tax Identification Number once you are prompted to do so. Say "Other professional services" at the second voice prompt, followed by "Credentialing," "Medical" and "Join the network" at respective subsequent prompts. This is the process for UHC Credentialing.

5. Wait until a credentialing specialist picks up the line. Answer all questions that the specialist asks you regarding your credentials. Note the ID number the specialist provides you at the end of the verification process.

6. Wait 25 to 30 business days for confirmation of your credentials. Note that the process can take 60 days if this is your first application to an insurer that uses the CAQH Universal Provider Datasource, which is used by most major insurers. Make sure to comply with any requests for additional information from either CAQH or UnitedHealthcare.

7. Check the status of your application as necessary by dialing the credentialing center number again and following all prompts according to Step 4 except the last one. Say "Get status" at the last prompt to obtain status information.

8. Await a contract in the mail or via email and sign it as directed before returning it to UnitedHealthcare. Note that if you are a member of a group practice and another provider in your group has already contracted with the insurer as a provider, you will simply be added on as an additional approved provider.

Things Needed

  • Tax identification number (TIN)
  • Healthcare practitioner license numbers including DEA controlled substance prescription license as applicable.
  • Malpractice insurance policy number and expiration date.

While the above serves as a guide to Provider Credentialing with United Healthcare, there are multiple points where errors are possible. To repeat the process would be extremely time consuming and tedious. Enrolling the help of automated Credentialing Services from a company like Eddy, can eliminate the risk of error, and greatly increase the response time from insurance companies such as United Healthcare. Reach out today to find out how Eddy can help you and your practice thrive.

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