Becoming a Provider
Credentialing Application Part 1
We have developed a system in Provider Credentialing that allows us to learn about you and your clinical experience and training. Our credentialing application is a two-part process. Part 1 of the application gives us your practice information, areas of expertise, training, and an understanding of your basic office procedures and practice. It allows us to examine your ability to provide services based upon the contractual agreements that we have both with our member and payor groups. This also gives you information about us, our minimum practice requirements, and clinical expectations for utilization management.
Our Network Management Committee will review Part 1 within 30 days upon receipt. Upon approval you will be sent Part 2 of the application, credentialing decisions are made within 180 days of receipt of full information Part 1 and 2. If we have any questions we will contact you. Part 2, more detailed information is required, which we will verify all educational, malpractice, and licensure information based on the National Committee for Quality Assurance Standards.
We would like to thank you in advance for your cooperation in completing this paperwork, and ensure that all information we receive will be kept completely confidential. Although this may seem a labor-intensive application process, it is our hope that you understand our approach and methods for ensuring a quality network and for establishing a mutually satisfying working relationship.
If an inquiry is made, and we have not received Part 1 within 30 days, we will consider your inquiry withdrawn. Please contact us for fee schedule information.
To contact Robin Staples, Provider Relations Manager, phone 866-925-5730 or email, rstaples@NewAvenuesOnline.com.
Download* the Credentialing Application Part 1.
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