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. Please click here for our Roster Upload template.

 

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: My facility is already contracted with Bright HealthCare, but I have not yet completed a Facility Credentialing Application. What should I do next?

A: Once contracted, facilities must complete the Facility Credentialing Application in order to become credentialed and begin seeing Bright HealthCare members. Download the application and submit the fully completed application. The credentialing process may take 60-90 days once your application is received.

The Facility Credentialing Application should only be completed once your facility is contracted with Bright HealthCare. If your facility is not yet contracted and you are interested in joining our network, please click “Join our Network!” to begin the process below.

 

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

A: Join our network!

   

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Additional Questions?

 

Contact Bright HealthCare Provider Services

 

Individual and Family Plans
(CA, GA, TX, UT, VA):
844-926-4525

 

(AL, AZ, CO, FL, IL, NC, NE, OK, SC, TN):
866-239-7191

 

Medicare Advantage Plans
(AZ, CO, FL, IL, NY):
844-926-4522