How to Get Credentialed with Humana in Arizona
Humana in Arizona: by the numbers
Verified figures for this state, not national averages.
- Counties containing at least one member
- 15
- Distinct plans
- 39
- Counties with a plan offered
- 15
- Medicare Advantage service area
- offers Medicare Advantage plans in 15 of the 15 counties in this state that have any MA plan
- Largest counties by enrollment
- Maricopa (125,941), Pima (31,162), Mohave (28,781), Yavapai (20,720), Pinal (18,039)
- Medicare Advantage members in state
- 254,957
Source: CMS Monthly Enrollment by Contract/Plan/State/County (2026-07) · CMS Medicare Advantage Plan Landscape (CY2026) · Verified July 2026
Quick Overview
Timeline
45 - 90 days
CAQH
Required
Re-credentialing
Every 3 year(s)
Delegated
Yes
How Humana Credentialing Actually Works
Verified July 2026Apply Through
Timeline
Providers contracted only on Humana Medicare products joining non delegated groups get a network effective date 30 calendar days after all required documentation is received
Recredentialing
At least every 36 months, with quarterly CAQH re-attestation reminders
CAQH ProView is mandatory (Arkansas excepted): a current, complete, attested profile with Humana granted access. The incomplete or unauthorized CAQH profile is Humana's dominant credentialing delay.
Behavioral health routing: Behavioral health is in house through Humana Behavioral Health Network, a wholly owned Humana subsidiary covering all 50 states, not an external carve out vendor.
The stall to avoid: Availity handles claims and eligibility but NOT credentialing status: application status lives on a phone line, (800) 626-2741. Keep CAQH attested quarterly and answer information requests fast.
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.
Arizona-Specific Requirements
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Arizona.
Complete Your CAQH ProView Profile
Humana requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.
Submit Your Application
Submit your completed enrollment package to Humana. You can start the process at their enrollment portal.
Track & Follow Up
Credentialing typically takes 45-90 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Humana?
Our specialists handle the entire Humana enrollment process: applications, follow-ups, and approvals in Arizona.
Required Documents Checklist
ATTESTATION_FORM
Provider attestation form
Board Certification
ConditionalRequired if board certified; highly recommended
CV/Resume
5-year work history minimum; gaps > 6 months must be explained
DEA License
ConditionalRequired if prescribing controlled substances
Malpractice Insurance
Medical Degree
Medical License
NPI Certificate
Professional Reference
3 peer references required
W9_FORM
Required for EFT/tax reporting setup
Enrollment Forms
Free Tools for Your Humana Enrollment
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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 Humana.
View Physician Credentialing Checklist →Contact Information
Business Services
National1-800-232-2006
Mon-Fri 7am-7pm CT
Credentialing Inquiries
National1-800-626-2741
ERA/EFT via Availity
National1-800-626-2741
Claims (Commercial)
National1-800-448-6262
Claims (Medicare)
National1-800-457-4708
Provider Appeals
National1-800-626-2741
Fax: 1-877-243-5813
EDI Support
National1-800-626-2741
prcredentials@humana.com
Fax: 1-866-423-6635
Quick Links
Humana in Other 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.