Medical Mutual - Health Plans for Life

Credentialing Requirements

Credentialing Requirements

Minimum credentialing requirements include, but are not limited to, the following:

  • Completed credentialing application with current attestation and release
  • Valid Professional License
  • Valid DEA Certificate (where applicable)
  • Proof of current malpractice coverage
    • The practitioner shall maintain adequate professional liability or malpractice insurance in an amount required by the applicable state law or at least $1,000,000 per occurrence/$1,000,000 annual aggregate, whichever is lower.
  • Appropriate Professional Training
    • Graduation from appropriate professional school
    • Residency/Fellowship
    • Board Certification
    • Appropriate professional experience
    • Provider’s specialty designation in the Company directory is at the discretion of the Credentialing Committee
  • Appropriate clinical privileges at a Network Hospital (where applicable)
  • Work History
  • Malpractice History
  • Office Site and Medical Record Review (where applicable)

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