Providers

Credentialing

Independent Care Health Plan credentials healthcare providers and organizations a minimum of once every three years, or more often, as necessary.

A completed application and signed attestation statement must be submitted for consideration. If you have any questions or to obtain an application, contact our QI Credentialing Delegation Coordinator, M – F 8:00 am to 4:30 pm at 414-225-4744, or kdenson@icare-wi.org An application and return envelope will be mailed to you from Rural Wisconsin Health Cooperative.

The following general criteria constitute the minimum requirements necessary to be considered for Independent Care provider credentialing:

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
   
   For physicians, credentialing criteria also includes:
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. All specialty providers: American Board of Medical Specialties Certification if applicable

Provider Resources

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