Credentialing
The Hartford Physician Hospital Organization (HPHO) Credentialing Program performs a core function of the organization for its physician members.
The HPHO has established standards for credentialing and recredentialing as promulgated by the National Committee on Quality Assurance (NCQA), federal and state regulatory agencies, and payer specific requirements.
The HPHO has been awarded delegation of credentialing by contracted insurance payers, many of which are NCQA Accredited.
Therefore, by joining the Hartford Physicians Association (HPA); the IPA component of the HPHO, a physician completes just one application process for participation with those authorized payers.
Once vetted, processed, and approved by the HPA Board of Directors, a physician member is then considered “credentialed” and a participating provider (PAR) for any HPHO contracted and delegated insurance plans and products in which the individual chooses to participate.
The HPHO continues to improve upon this process to avoid redundancy. Recredentialing forms are pre-populated with known information from the last cycle of credentialing so that the member can simply update the information.
Communications are predominantly electronic.
UnitedHealthcare Mid-Level Direct Credentialing Form
The HPHO and UnitedHealthcare have agreed upon a process by which member groups can request individual credentialing of their Mid-Level practitioners via a spreadhseet form.
Click here to open the form, then 'save' it to your computer.
Complete the information requested and send the form via facsimile directly to UnitedHealthcare. This process is offered by UnitedHealthcare only to HPHO applicants.
For more information please contact:
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