How to Get Credentialed with PEIA PPB Plans (UMR) in West Virginia
Quick Overview
Timeline
Varies
CAQH
Not Required
Re-credentialing
Every 3 year(s)
Delegated
No
West Virginia-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 West Virginia.
Prepare Your Application
Complete PEIA PPB Plans (UMR)'s provider enrollment application with all required information and supporting documentation.
Submit Your Application
Submit your completed enrollment package to PEIA PPB Plans (UMR).
Track & Follow Up
Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.
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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 PEIA PPB Plans (UMR).
View Physician Credentialing Checklist →Quick Links
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Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.