Providers

Credentialing

Independent Care Health Plan credentials physicians and other allied healthcare professionals to assure minimum qualifications for the iCare network of providers. Credential review occurs once every three years, or more often, as necessary.

To begin the credentialing process, a completed application and signed attestation statement must be submitted for consideration. To obtain an application, contact our QI Credentialing Delegation Coordinator via FAX at 414-231-1092. An application and return envelope will be mailed to you from Rural Wisconsin Health Cooperative, iCare’s primary source verification organization.

The minimum requirements necessary for Independent Care provider credentialing are:

Credentialing Criteria

1. A current valid, unrestricted Wisconsin license or certification if licensure is not available
2. Medicare and Wisconsin Medicaid certification
3. Current professional liability insurance adequately meeting minimum state requirements as defined by State of Wisconsin Statute and Administrative Code relating to practice of Medicine number 655.23
4. Completed appropriate education and training for applied specialty
5. Acceptable malpractice liability claims history
6. Demonstrates sanction-free status by federal and state regulatory authorities
7. Demonstrates lack of physical or mental impairment, including chemical dependency, that may impair the provider’s ability to practice or may pose a risk of harm to patients




Additional criteria for physicians:

8. A current valid unrestricted Drug Enforcement Administration (DEA) certificate, if applicable to profession
9. Current unrestricted admitting privileges at an Independent Care participating hospital. If privileges are not present the Credentials Review Committee may consider a waiver following review of coverage arrangements. Provider must give written evidence of coverage by a participating Independent Care provider or facility.
10. Evidence of 24 hours per day, 7 day per week professional coverage arrangements.

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