Credentialing
Providers who wish to contract with CareSource must first be credentialed. Through credentialing, CareSource checks the qualifications and performance of physicians and other health care practitioners. Providers are recredentialed a minimum of every three years and are considered to be recredentialed unless otherwise notified.
CareSource credentials providers using guidelines from the Michigan Department of Community Health (MDCH), the National Committee for Quality Assurance (NCQA) and URAC. Our Vice President/ Senior Medical Director is responsible for the credentialing and recredentialing program.
Two Ways to Become Credentialed
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CAQH Universal Credentialing Datasource
The Council for Affordable Quality Healthcare operates a website that allows providers to enter data one time, at no cost, to satisfy the credentialing and recredentialing requirements of participating health insurance plans.
If you use the CAQH service, you only need to select CareSource as an authorized
user of your data on the CAQH website and provide a CareSource Provider Relations representative with the authorization number required to access it.
For more information, please call 1-888-599-1771 or log on to www.caqh.org.
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MAHP Standard Practitioner Credentialing Form
The Michigan Association of Health Plans has a Standard Practitioner Credentialing Form for use by health care organizations in the state. The form costs nothing to complete. For more information, please call (517) 371-3181 or visit MAHP website at www.mahp.org.
For questions about credentialing, call CareSource at 1-800-390-7102, and follow the prompts to be directed to one of our Credentialing staff. We can research the status of the provider's application in the credentialing process or what documents might still be needed from the provider.
For more information about credentialing, please see the Provider Manual.