Credentialing is the process of obtaining and reviewing documentation to determine participation status in a health plan. The documentation may include, but is not limited to, the applicant’s education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Generally, the terms credentialing and recredentialing include the review of the information and documentation collected, as well as verification that the information is accurate and complete.
- Facilities and organizational providers that are already contracted with Humana but need to be credentialed should download our , PDF opens new window application and return it by fax to 1-502-508-0521 or by email to firstname.lastname@example.org.
- Puerto Rico healthcare professionals interested in credentialing should send an email to PRCredentials@humana.com or call 1-877-384-5037. The information below does not apply to Puerto Rico.
- The credentialing and recredentialing policies can be viewed , PDF opens new window
- For answers to questions regarding credentialing status or the process described below, please call 1-800-626-2741 and choose the option that says, “Have a question about a contract?” You also can send an email to email@example.com.