Commercial Payers
6 guidesThe largest commercial insurance carriers covering the majority of privately insured Americans.
Aetna CVS Health
Enrollment guide for Aetna provider network including individual, group, and Medicare Advantage plans.
Cigna Healthcare The Cigna Group
Cigna credentialing requirements, CAQH submission, and behavioral health panel enrollment.
UnitedHealthcare UnitedHealth Group
UHC in-network enrollment for commercial, Medicare Advantage, and Community Plan products.
Blue Cross Blue Shield Blue Cross Blue Shield Association (independent member companies)
BCBS credentialing by state plan — BlueCard and local plan enrollment requirements.
Humana Humana Inc.
Humana provider enrollment for commercial, Medicare Advantage, and Medicaid managed care.
Anthem Blue Cross and Blue Shield Elevance Health
Anthem credentialing for commercial and managed Medicaid markets across 14 states.
Government Payers
4 guidesFederal and military health programs. Enrollment is required before billing; timelines vary by program.
Medicare Centers for Medicare & Medicaid Services (CMS)
Medicare enrollment via PECOS — Part B, Medicare Advantage, and DME supplier enrollment.
Medicaid Federal-state Medicaid program (CMS and state Medicaid agencies)
State-by-state Medicaid fee-for-service and managed care enrollment requirements.
TRICARE Defense Health Agency (U.S. Department of Defense)
Tricare network participation for active duty, veterans, and military family coverage.
VA Community Care / CHAMPVA U.S. Department of Veterans Affairs
VA Community Care Network and CHAMPVA credentialing for veteran patient care.
Managed Care Plans
2 guidesCentene Centene Corporation
Centene Medicaid managed care enrollment across all state health plans.
Molina Healthcare Molina Healthcare, Inc.
Molina Medicaid and Marketplace credentialing requirements and timelines.
Regional & Specialty Plans
13 guidesRegional health plans and specialty networks that serve specific markets or patient populations.
Kaiser Permanente Kaiser Foundation Health Plan, Inc.
Kaiser credentialing for the integrated care model across California, Pacific NW, and Mid-Atlantic.
Highmark Highmark Health
Highmark credentialing guidance for its market-specific participation and contracting process.
Health Net Centene Corporation
Health Net provider participation and credentialing guidance by market and provider type.
Amerigroup Elevance Health (Anthem)
Amerigroup (Elevance Health) Medicaid managed care enrollment across 15 states.
WellCare Centene Corporation
Wellcare provider participation guidance for state-specific Medicare and Medicaid plans.
Oscar Health Oscar Health, Inc.
Oscar provider enrollment for ACA Marketplace and employer-sponsored plans.
Bright Health (legacy) NeueHealth (formerly Bright Health Group)
Bright Health network credentialing for individual and Medicare Advantage markets.
Ambetter Centene Corporation (ACA Marketplace brand)
Ambetter provider participation guidance for state-specific ACA Marketplace plans.
Magellan Health Centene Corporation
Magellan behavioral health network credentialing for psychiatrists, psychologists, and therapists.
Optum UnitedHealth Group
Optum behavioral health participation guidance including Provider Express credentialing.
Coventry Health Care Aetna (CVS Health)
Coventry Health Care (Aetna) credentialing guidance for its regional markets.
Community Health Plan of Washington (CHPW) Community Health Plan of Washington
CHPW network enrollment guidance for Washington Apple Health providers.
Tufts Health Plan Point32Health
Tufts Health Plan (Point32Health) credentialing across Massachusetts, New Hampshire, and Rhode Island.
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