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If you are a new independent provider or group and have credentialing questions please email CHDProviderRelations@eCommunity.com.
Community Health Direct (CHD) holds delegated credentialing agreements with the majority of payers. Due to the delegated agreements, we can provide one effective date with payers. **Anthem and Encore effective dates are 30 days after the provider’s effective date.
To become a participating provider with Community Health Direct you must have a completed and up-to-date CAQH application. If you would like Community Health Direct to obtain this application for you, please complete the New Provider Checklist form. Otherwise, please see the CAQH website for additional information at www.caqh.org.
To become a participating provider you need to complete and submit the Provider Data Form and send it to CHDProviderRelations@eCommunity.com to get started.
CHD will credential and enroll the following provider types: MD, DO, DPM, DDS, NP, PA, CNS, CNM, CRNA, OD, DC, LCSW, LMHC, LMFT, LCAC
The credentialing and enrollment process can take anywhere from 90 to 120 days from the time you submit a completed application to the date you are effective with the payers.
CHD follows credentialing guidelines from the National Committee for Quality Assurance (NCQA). We will obtain your CAQH application with your permission and then will conduct a Primary Source Verification on the data contained within the CAQH application. We will also run the standard sanction checks such as OIG, SAM, and IDOI and prepare the information to be reviewed and approved by our Credentials Committee.
Once your data form is received, a credentialing coordinator will reach out to you within two business days to acknowledge receipt, introduce themselves, and advise of any items needed to complete the application. Next, the coordinator will perform the credentialing process and prepare your file to be presented for approval to our CHD Credentials Committee. Once the committee approves your credentialing, you will become effective with the payers on the first of the following month. You will receive a letter within 10 business days after the committee meets, advising you of your CHD approval, effective date, and a list of plans/products included in your contract.
Contact the CHD Provider Relations Department at 317-621-7581 at any time during regular business hours. If you’ve been made aware of the Credentialing Coordinator assigned to your file you can also contact them directly at any time during the process as well.
