As a Medicaid managed care organization, Community Health Choice must utilize the Texas Association of Health Plans’ (TAHP) contracted Credentialing Verification Organization (CVO) as part of its credentialing and recredentialing process regardless of membership in the TAHP. The CVO is responsible for receiving completed applications, attestations and primary source verification documents. At least once every three years, Community Health Choice must review and approve the credentials of all participating licensed and unlicensed Providers who participate in the network.
Upon determination by Verisyi (CVO) that your application is complete, the credentialing process can take up to 90 days.
If you are part of a group that already participates with Community Health Choice, you can request expedited credentialing, which will allow you to serve Medicaid recipients on a provisional basis while your credentialing application is pending. To qualify for expedited credentialing per Sec. 1452 of the Texas Insurance Code, you must meet all of the following criteria:
• Be a member of an established healthcare provider group that has a current contract in force with Community
• Be a provider type specified in TIC 1452
• Be licensed by the State of Texas, and in good standing with the appropriate state licensing Board
• Agree to comply with the terms of the contract
• Submit all documentation and information required to begin the credentialing process
Important: Please ensure that your credentials and information are current with CAQH to avoid any delays in the credentialing or recredentialing process