Bright Health Credentialing

Find answers to your important credentialing questions

Frequently Asked Questions

Q: How long does the credentialing process typically take?

A: Credentialing typically takes between 60-90 days from the time a provider roster is received to the time a provider is reviewed at Credentialing Committee. Ensuring a provider’s CAQH profile is updated, that Bright is authorized to access a CAQH profile, and that roster data is submitted accurately will all help reduce processing time.

 

Q: A provider is no longer with our group or his/her information has changed. Can Bright HealthCare update the provider within its system?

A: The easiest way to have changes (of any kind) to your provider roster reflected is to re-submit your roster with the relevant changes inputted. For Terms, please ensure you include a “Term Date” in the respective field.

 

Q: How do I receive an update on provider loading and/or credentialing status?

A: If you would like to know the credentialing status of your providers, please email credentialing@brighthealthplan.com. This email address will be responsive to questions specifically regarding credentialing status.

 

Q: When will providers receive confirmation of in-network status?

A: Providers will receive a letter in the mail when they have passed credentialing. Please note that providers cannot see Bright HealthCare members until they have passed credentialing and have reached their contract effective date.

 

Q: When can I start seeing patients?

A: Providers can only start seeing Bright HealthCare patients after they’ve been credentialed. In the case of direct credentialing that will be when they receive a Pass credentialing notification.

 

Q: What if I’m not contracted with Bright HealthCare?

A: Join our network!