The Health Insurers and Credentialing Intermediaries Uniform Credentialing Form Act of 2002 authorizes the Commissioner of the Department of Insurance, Securities and Banking (DISB) to issue rules implementing standardized credentialing and recredentialing procedures for healthcare providers in the District of Columbia.
DISB regulations require health insurers and credentialing intermediaries to accept the most current version of the Council for Affordable Quality Healthcare (CAQH) Provider Application as the sole application for credentialing and recredentialing providers participating on a health insurer’s provider panel.
Healthcare providers may complete and submit the credentialing or recredentialing application online through the CAQH Provider Data Portal, formerly known as CAQH ProView. The application is typically generated directly from the provider’s online CAQH profile and transmitted electronically to authorized health plans. In most cases, there is no need to download or submit a fillable PDF.
Providers or credentialing intermediaries who require a hard copy may request one directly from their health plan or by contacting DISB.
Note: DISB does not process or review provider credentialing or recredentialing applications. Completed applications must be submitted to the appropriate health insurer or credentialing intermediary.
For additional questions or assistance, please contact DISB’s Insurance Bureau at [email protected].
