Commercial

How to Get Credentialed with WellCare in Michigan

Network: Open
60-90 Days CAQH Required

Quick Overview

Timeline

60 - 90 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Michigan.

2

Complete Your CAQH ProView Profile

WellCare requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.

3

Submit Your Application

Submit your completed enrollment package to WellCare.

4

Track & Follow Up

Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Board Certification

Conditional

Required if board certified; highly recommended

CV/Resume

5-year work history minimum; gaps > 6 months must be explained

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

3 peer references required

Enrollment Forms

CAQH ProView

Universal credentialing application used by most commercial and BCBS payers.

Required
Online Open →

Key Credentialing Terms

CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
Primary Source Verification
The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...
Provider Enrollment
The process by which a healthcare provider applies to participate in an insurance payer's network, allowing the provider...
Re-credentialing
The periodic process, typically occurring every three years, in which a provider's credentials are re-verified to ensure...

Credentialing Checklist

Make sure you have everything ready before applying to WellCare.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-866-530-9491

Mon-Fri 8am-6pm ET

Provider Services

National

1-866-530-9491

Claims & Billing

National

1-866-530-9491

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