Become a Participating Provider
Ready to join our network? Here’s what comes next.
Start the Contracting Process
Fill out the New Health Partner Contract Form to get started.
If you offer medical services and want more information about becoming a participating provider, please submit the New Health Partner Contract Form.
Your Application Status
Once you submit your application, you will receive a confirmation email. Please save this email, as it will contain your Application ID.
You can check your application status on the Provider Portal. You will need to enter your NPI and Application ID to view your status.
Complete your application with supporting documents.
Providers who wish to contract with CareSource must also be credentialed. Through credentialing, we check 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.
Contracting and Recredentialing Process
CareSource credentials providers using guidelines from the Centers for Medicare and Medicaid Services and the National Committee for Quality Assurance (NCQA) and as defined by West Virginia Code and the West Virginia Department of Insurance. Our Vice President/Senior Medical Director is responsible for the credentialing and recredentialing program.
West Virginia Department of Insurance and CareSource require that you submit your National Provider Identifier (NPI) number to CareSource along with the completed West Virginia uniform credentialing and recredentialing form or the Council for Affordable Quality Healthcare (CAQH) application.
At CareSource, we work with our healthcare providers to ensure the highest quality of care for our members, and we are committed to making it easy for you and your staff to do business with us. This module of the Provider Education Series shares CareSource’s philosophy, product offerings, and process for becoming a new CareSource Health Partner.
CareSource is committed to a seamless and expedient credentialing and re-credentialing process. Watch this video to learn about credentialing requirements and best practices for submitting the required documentation to CareSource.
CareSource is a participating organization with CAQH. Please make sure that we have access to your provider application before you submit your CAQH number as referenced above:
- Log on to CAQH using your account information.
- Select the Authorization tab.
- Make sure CareSource Marketplace West Virginia is listed as an authorized health plan.
- If not, check the Authorized box to add.
Please also include the following documents:
- Drug Enforcement Administration (DEA) certificate
- Malpractice insurance face sheet
- Clinical Laboratory Improvement Awards (CLIA) certificate, if applicable
- Collaborative agreement for Prescriptive Authority (CAPA), if applicable
It is essential that all documents are complete and current, or CareSource will discontinue the contracting and credentialing process.
If you have missing or expired documents, the Credentialing staff will send you a letter with instructions to correct and submit the updated information.
Check Your Status
You can check your application and credentialing status on the Provider Portal. You will need to enter your NPI and Application ID. The tool will allow you to view your status in the credentialing process as well as specific credentialing documents.
Once we complete the credentialing process, you will receive a letter from us.
Learn how to work with CareSource.
Welcome to the CareSource network! Once you receive your Welcome Letter from CareSource with your CareSource ID number, you have completed the contracting and credentialing process.
As you prepare to see CareSource members, we encourage you to familiarize yourself with our plan, tools and resources.
Create a Provider Portal account.
If you are not registered with CareSource’s Provider Portal, please follow these easy steps:
- Visit the Provider Portal.
- Click on the “Register for an account” button and complete the three-step registration process. You will need your Tax ID number and your CareSource/ Provider Number, located in your welcome letter.
- Click the “Continue” button.
- Note the username and password you create so that you can access the portal’s many helpful tools.
Take the provider orientation training.
View the Provider Orientation to welcome you and help you work with CareSource.
Check out the Training & Events page for any upcoming live orientations.
Learn About CareSource
Get Started With CareSource
Work With CareSource
Use Our Provider Tools
Set up electronic payments.
CareSource has partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:
- Electronic fund transfer (EFT) – preferred
- Virtual Card Payment (QuicRemit) – Standard bank and card issuer fees apply*
- Paper Checks
*Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card.
Questions? Call ECHO Customer Support at 1-888-834-3511.
Bookmark news from CareSource.
We strive to make partnering with us simple. We’re aware things may change in the way we do business with you and want to communicate these changes to you in an efficient manner.
Visit the Updates & Announcements page frequently to find all the latest CareSource news.
Share the good news!
We encourage you to let your patients know you accept CareSource by sharing on your social media platforms. Visit our Provider Social Media Kit (coming soon) to get started.
Explore training and resources.
We support our provider network with online resources and trainings on topics relevant to your practice. Check out the Training & Events page.
Need help? If you have additional general questions about getting contracted, please call CareSource’s Provider Services at 1-855-202-1091.
We are always looking for ways to improve our network. If you have any suggestions or would like to refer a provider to us, we want to hear from you. Share your ideas or referrals on the Access Opportunity Form.