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Credentialing

Photo Credit: CDC/Judy Schmidt

Provider participation in the Children’s Medical Services (CMS) plans (MMA-Title 19 and CHIP-Title 21) consists of a two-step process. First, providers must be credentialed through the CMS plan. Next, providers must be contracted through one of CMS’s two Integrated Care System (ICS) partners.

Effective March 21, 2017, Community Care Plan (CCP) will begin using CAQH to more efficiently credential CMS Plan providers. CAQH ProView is an online provider data collection solution.  It enables physicians and other healthcare professionals to enter information, free-of-charge, into a secure central database and authorize healthcare organizations such as CMS Plan and CCP to access the information.

To begin a new credentialing application, providers will complete and submit the CMS Letter of Intent Requirements document. Once the provider receives their application link from CCP, each provider will be required to register with CAQH, if not already registered, and authorize CCP to access their information electronically. There is no fee for this. The provider can then access the CAQH application option on the Morrisey application website.

For detailed information on the process, please view the CMS Instructions. Providers with questions about this new feature should contact credentialingdept@ccpcares.org.