Managed Care Organization

How to Get Credentialed with UnitedHealthcare Community Plan in Wisconsin

Network: Open
CAQH Required

Quick Overview

Timeline

Varies

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

Wisconsin-Specific Requirements

UHC Community Plan of Wisconsin participates in the BadgerCare Plus and SSI managed care programs. Providers must first enroll with Wisconsin Medicaid through ForwardHealth, then apply to UHC via CAQH ProView. Active Wisconsin medical license and NPI are required. Service areas cover select counties across the state. BadgerCare Plus serves low-income families, children, pregnant women, and childless adults.

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 Wisconsin.

2

Complete Your CAQH ProView Profile

UnitedHealthcare Community Plan 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 UnitedHealthcare Community Plan.

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

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

Contact Information

Credentialing

National

Network Enrollment

National

Quick Links

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UnitedHealthcare Community Plan in Other States

Alabama Arizona California Colorado District Of Columbia Florida Georgia Hawaii Iowa Illinois

Other Payers in Wisconsin

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Anthem Blue Cross and Blue Shield of Wisconsin Wisconsin Medicaid Molina Healthcare (Medicaid)
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