Clover Health
Credentialing and enrollment guides for Clover Health across 8 states.
Quick Overview
Timeline
45 - 60 days
CAQH
Required
Re-credentialing
Every 3 year(s)
States Available
8
How Clover Health Credentialing Actually Works
Verified July 2026Apply Through
Timeline
Not published by the payer
Recredentialing
Not published by the payer
Clover Health is a Medicare Advantage focused plan. Credentialing follows the standard CMS and NCQA rules and works from your CAQH ProView data; apply through the plan's provider enrollment channel and confirm its current service counties first.
The stall to avoid: Growth stage Medicare Advantage plans change service areas year to year: confirm the plan operates in your county for the current plan year before applying.
From PayerReady's payer enrollment research, built from the payer's own provider manuals and enrollment pages. Payer processes change; when a fact is not published by the payer, we say so rather than guess.
About Clover Health
Clover Health is a health insurance plan operated by Clover Health Investments Corp., offering healthcare coverage and provider network services. They credential physicians, specialists, and allied health professionals for their managed care networks.
How to Get Credentialed
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and board certifications.
Complete Your CAQH ProView Profile
Clover Health requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org.
Submit Your Application
Submit your completed enrollment package to Clover Health. Select your state below for state-specific submission details.
Track & Follow Up
Credentialing typically takes 45-60 days. Monitor your application and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Clover Health?
Our specialists handle the entire Clover Health enrollment process: applications, follow-ups, and approvals across all 50 states.
Required Documents
Board Certification
Required if board certified; highly recommended
CV/Resume
DEA License
Required if prescribing controlled substances
Malpractice Insurance
Medical License
NPI Certificate
Contact Information
Provider Credentialing
1-888-657-1207
Mon-Fri 8am-5pm
Provider Services
1-888-657-1207
Claims & Billing
1-888-657-1207
Quick Links
Available States
Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.
Select Your State
Choose your state for Clover Health-specific credentialing details including timelines, contacts, and local requirements.
Clover Health credentialing requirements by state
Clover Health enrollment is not identical everywhere. The table below lists what actually differs across the 8 states Clover Health operates in — network status, local plan names, portals and the state-specific conditions our credentialing team has recorded.
| State | MA members | Network | State-specific notes |
|---|---|---|---|
| Arizona | — | Open | Clover Health Arizona. Medicare Advantage plans for 65+ population. Service areas include Maricopa County (Phoenix metro). Apply via Clover Health provider portal or CAQH ProView. Clover Assistant AI clinical decision support tool integrated into provider workflow. Active Arizona medical license, NPI, Medicare enrollment (PECOS), and malpractice insurance required. Processing: 30-60 days. |
| Georgia | 20,862 | Open | Clover Health Georgia. Medicare Advantage plans. Service areas include metro Atlanta (Fulton, DeKalb, Cobb, Gwinnett counties) and surrounding areas. Apply via Clover Health provider portal or CAQH ProView. Clover Assistant AI platform provides real-time clinical insights during patient visits. Active Georgia medical license, NPI, Medicare enrollment (PECOS), and malpractice insurance required. Processing: 30-60 days. |
| Mississippi | — | Open | Clover Health Mississippi. Medicare Advantage plans. Service areas include select counties. Apply via Clover Health provider portal or CAQH ProView. Clover Assistant AI tool supports clinical decision-making at point of care. Active Mississippi medical license, NPI, Medicare enrollment (PECOS), and malpractice insurance required. Processing: 30-60 days. |
| New Jersey | 130,632 | Open | Clover Health New Jersey (headquartered here). Medicare Advantage plans — NJ is Clover's largest and original market. Service areas cover most New Jersey counties. Apply via Clover Health provider portal or CAQH ProView. Clover Assistant AI platform is deeply integrated into NJ provider workflows. Active New Jersey medical license, NPI, Medicare enrollment (PECOS), and malpractice insurance required. Processing: 30-60 days. |
| Pennsylvania | 674 | Open | Clover Health Pennsylvania. Medicare Advantage plans. Service areas include the greater Philadelphia region (Bucks, Chester, Delaware, Montgomery, Philadelphia counties). Apply via Clover Health provider portal or CAQH ProView. Clover Assistant AI platform for clinical decision support at point of care. Active Pennsylvania medical license, NPI, Medicare enrollment (PECOS), and malpractice insurance required. Processing: 30-60 days. |
| South Carolina | 3,406 | Open | Clover Health South Carolina. Medicare Advantage plans. Service areas include select counties in the state. Apply via Clover Health provider portal or CAQH ProView. Clover Assistant AI tool provides real-time clinical insights during patient visits. Active South Carolina medical license, NPI, Medicare enrollment (PECOS), and malpractice insurance required. Processing: 30-60 days. |
| Tennessee | — | Open | Clover Health Tennessee. Medicare Advantage plans. Service areas include Davidson County (Nashville metro) and surrounding counties. Apply via Clover Health provider portal or CAQH ProView. Clover Assistant AI platform integrated into provider workflow for clinical decision support. Active Tennessee medical license, NPI, Medicare enrollment (PECOS), and malpractice insurance required. Processing: 30-60 days. |
| Texas | 360 | Open | Clover Health Texas. Medicare Advantage plans. Service areas include Harris County (Houston metro) and surrounding areas. Apply via Clover Health provider portal or CAQH ProView. Clover Assistant AI clinical platform provides real-time insights at point of care. Active Texas medical license, DEA registration (if prescribing), NPI, Medicare enrollment (PECOS), and malpractice insurance required. Processing: 30-60 days. |
MA member counts: CMS Medicare Advantage Plan Landscape (CY2026), verified July 2026. Compiled and maintained by the PayerReady credentialing team from payer portals and direct payer contact. Last verified March 22, 2026. Network status changes without notice — confirm before you file.
Common questions about Clover Health credentialing
How long does Clover Health credentialing take?
Clover Health credentialing typically takes 45–60 days from a complete submission to an approved effective date. Incomplete applications are the main cause of delay: a missing document or an unattested CAQH profile restarts the clock rather than pausing it.
Does Clover Health require CAQH?
Yes. Clover Health pulls provider data from CAQH ProView, so your profile must be complete, attested and shared with Clover Health before the application can move. CAQH re-attestation runs on a 120-day cycle, and a lapsed attestation stalls both new enrollments and recredentialing.
Which states does Clover Health operate in?
Clover Health has credentialing operations in 8 states. 8 of those 8 currently show an open panel. Requirements are not uniform: local plan names, provider portals and state-specific conditions differ, which is what the state-by-state table above records.