Credentialing of Physicians and Other Health Care Providers

Humana participates with the Council for Affordable Quality Healthcare (CAQH) Universal Provider Datasource®, an online service to help physicians and other health care providers more easily and cost effectively provide required credentialing information to health care organizations and health plans.

Universal Provider Datasource

Humana and ChoiceCare® network physicians and certain other health care providers can utilize CAQH's Universal Provider Datasource for recredentialing, instead of completing a Humana-specific credentialing application. New physicians and other health care providers joining the network may also use CAQH for the initial credentialing process. Health care providers who may be eligible through Humana to use the Universal Provider Datasource include those listed in the chart below.

Potentially eligible health care providers
Audiologist Certified registered nurse Certified registered nurse anesthetist Clinical nurse specialist
Clinical psychologist Clinical social worker Doctor of chiropractic Doctor of dental medicine
Doctor of dental surgery Doctor of osteopathy Doctor of podiatric medicine Licensed practical nurse
Marriage/family therapist Medical doctor Midwife Neuropsychologist
Nurse midwife Nurse practitioner Occupational therapist Optometrist
Physician assistant Physical therapist Professional counselor Registered nurse
Registered nurse first assistant Speech pathologist    

Universal Provider Datasource provides a fast and easy way to securely submit credentialing information to multiple health plans and networks by entering information just one time. Application data can be submitted anytime through the convenience of the Internet or by fax. This simplified credentialing process reduces paperwork and saves time for health care providers and their staff. Best of all, this service is provided at no cost to participating providers.

How it works

Humana issues a unique CAQH identification number to each provider who wants to be a part of CAQH. Then, the provider creates a user name and confidential password, which is used to complete the application online.

The process incorporates the Standard Application Data Set and also, where appropriate, accounts for any additional credentialing information required by states with specific application mandates. Before the completed application is available to any participating organization or health plan, the provider must authorize release of the data. Each organization that has included the provider on its roster will appear on the authorization screen for the provider to review and authorize.

The applications are stored in an online database and are always available to the provider to update, review or print.

Once a provider completes the process, automatic reminders are sent each quarter to prompt a review and update of the information. It is the provider's responsibility to maintain accurate and complete information. Updates can be entered at any time.

Participating Humana network providers and ChoiceCare network providers who do not have a CAQH ID and wish to participate with CAQH may contact our credentialing department at crees@humana.com. This is the appropriate contact address for CAQH ID numbers for participating providers only. Nonparticipating providers interested in joining our network should use our online contracting form.

In order to process the CAQH ID request, the following information is required:

  • Provider's full name
  • Date of birth
  • National Provider Identifier (NPI)
  • Specialty
  • Office complete address
  • Office phone number

Upon receipt of all required information, the unique CAQH number will be issued to the provider. CAQH will also mail a welcome packet to the provider.

For more information about CAQH, please visit CAQH's website.