Centralized Credentialing Launching Soon in Nebraska

Starting January 1, 2025, the UnitedHealthcare Community Plan of Nebraska will put in force a new, centralized credentialing method for care carriers. This manner could be managed with the centralized verification corporation (CVO), Verisys. Verisys will perform a single streamlined verification technique for numerous Nebraska managed care groups (MCOs), including:

  • UnitedHealthcare Community Plan of Nebraska
  • Nebraska Total Care
  • Molina Healthcare

Why centralized credentialing?

The new system eliminates the need to conduct individual credentialing procedures with every.
MCO. All could be completed right now.

Who’s required to take participate

The varieties of care companies required to participate encompass:

  • Medical
  • Behavioural fitness
  • Dental

Who’s excluded

The following MCO delegates are excluded:

  • March Vision Care vendors
  • Optum RX care providers
  • Non-emergency clinical transportation (NEMT) care carriers
  • Other entities, along with Independent Physician Practice Associations (IPA)
  • Physician clinic organizations (PHO) who hold delegated credentialing agreements

When to begin the re-credentialing method

Recredentialing starts somewhere in between the mid-2025. You’ll receive a letter from Verisys within the mail 6 months before your re-credentialing due date. The CVO will carry out credentialing every 3 years.

Note: Centralized re-credentialing no longer updates the Medicaid company enrollment screening procedure. All Medicaid care vendors must sign up with this system via Maximus. More statistics on a way to join the Nebraska Medicaid Program are on the Nebraska Department of Health & Human Services official website.

 


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