Joining our network is easy!
You make your patients' lives better. We'll do the same for you.
Thanks for your interest!
We are glad to hear that you are interested in joining the Wellpoint network. We have a diverse network of exceptional healthcare professionals who ensure our members have uninterrupted access to the healthcare they need.
Our prior authorization, referrals, claims, and payment processes are streamlined to help you focus on what you do best — caring for your patients.
Credentialing with Wellpoint
Credentialing is the process Wellpoint uses to evaluate and select licensed independent practitioners to provide care to our members. Wellpoint uses the Council for Affordable Quality Healthcare (CAQH) ProView application for credentialing. This secure and private portal reduces the amount of paperwork you need to fill out to complete the credentialing process.
Credentialing process
1. Register with CAQH (if you are not already registered). You may self-register by visiting thee CAQH Provider Data Portal. This is a secure and private website.
2. Authorize Wellpoint so we can access your credentialing information. If you are already registered with CAQH, you will need to give us permission to review your information.
3. If you need assistance, please review the New Provider Quick Reference Guide or call the CAQH Provider help line at 888-599-1771.
4. Review and update your application. Please ensure all sections of the application are complete and accurate.
Credentialing application requirements
A complete application includes:
- Your signature and application date
- Your CAQH status of initial Application Complete or Reattestation
- Your current license to practice in each state where services are provided
- Your education/training to support requested specialty(ies) (or documentation that you will complete training within 60 days of application)
- Your current hospital privilege information
- Your current DEA or CDS certificate in each state where services are provided
- Explanations to questions on the application
- Five years of work history, in month/year format
- Your current professional liability insurance
- Your allowing a site review within 30 days of our request if applicable
The credentialing process typically takes 45 days from the time the credentialing department receives your completed CAQH application.
Recredentialing
Wellpoint recredentials network providers every three years. If your CAQH application is current and complete at that time, no additional effort on your part may be required. If your CAQH is expired or missing information, we will contact you to update the information.
Non-response to recredentialing requests
If you do not update your CAQH or supply the required information for recredentialing by the due date, your application will be considered incomplete and will result in an administrative termination from the network.
Provider maintenance and demographic updates
Providers contracted with Wellpoint should utilize Availity’s Provider Demographic Management (PDM) application to request changes to existing practice information. Learn more by visiting our Provider maintenance and demographic updates page.
Availity registration
If your organization is not currently registered with Availity, the person(s) designated as your administrator(s) should register to obtain an Availity account. You may also navigate directly to Availity’s registration website by selecting the link labeled ‘Availity registration’.
Need more help?
Please refer to your provider manual or contact our Provider Services team to help answer any questions you may have about Healthy Blue.
Call Provider Services:
Our Provider Services team is available Monday – Friday, 8:00 a.m. to 5:00 p.m.
Phone: 1-844-421-5663
Fax Provider Services :
Fax: 1-877-799-4129
Interested in becoming a provider in the Wellpoint network?
We look forward to working with you to provide quality service for our members.