MD
P
int
Preparing Experience...
MD
P
int
Solutions
Pricing
Company
Contact us
info@mdpoint.com
MD
P
int
Solutions
Pricing
Company
Contact us
info@mdpoint.com
Credentialing Checklist
Provider/Facility Details
Name
SSN No or (Last 4 Digit of Your SSN)
DOB
Percentage of Ownership
NPPES Username
NPPES Password
Specialty
Email Address *
Cell No.
Facility/Agency Name
Tax ID
NPI Type 1 (individual)
NPI Type 2 (group)
Primary Service Address
Pay to Address
Mailing Address
Office Hours at location
Appointment Phone No.
Fax No.
Office Email
Office Manager/Contact
CAQH Logins
Documents
State License
IRS Letter
Accreditation Letter
Malpractice/ PLI / COI
W9 Form
Voided Check/ Bank Letter
Owner Driving License
Resume / CV
Insurance Company
ACI Specialty Benefits
Aetna
Amerigroup
AmeriHealth
Anthem
Banner Health
Beacon Health Options
Blue Cross Blue Shield
CareConnect Health Plan
Centene Corporation
CHAMPVA
Choice Health-Care Network
Cigna and Evernorth
ComPsych
EmblemHealth
GHI
Great-West Life
Health Net
HealthNet 1MHN
Health Plus
Horizon Blue Cross
Horizon Blue Cross and Blue
Horizon Healthcare
Humana
Kaiser Permanente
Magellan
MagnaCare
Medicaid
Medicare
Mercy Care
Meridian
Molina Healthcare
MultiPlan
Optum
Oscar Health
Oxford
Phoenix Health Plan
Sharp Health Plan
TRICARE
UMR
UnitedHealthcare UHC | UBH
VA Community Care Network
Other
Write Other Insurance Company that you want to be registered that are not mentioned in our list:
Send