Credentialing

IPN sets the standard for network participation

IPN is responsible for credentialing all network providers, facilities, and ancillary entities. The credentialing process has been certified to meet NCQA requirements and complies with state and federal statutes as well. Credentialing through IPN ensures the highest performance standards for members and simplifies the payor qualification process for providers. Network providers complete only one application to cover all IPN contracted payors.   

IPN conducts an extensive performance review as part of the credentialing process. As part of this process, IPN solicits information from various resources including national certifying boards, appropriate state licensing boards, the Office of the Inspector General Exclusions list, the National Practitioner Data Bank and other sources as required. Providers are not considered participating in the network until after the credentialing and contracting processes are complete. 

• For Frequently Asked Questions: see Credentialing FAQs
• For Credentialing Matrix or Credentialing Criteria and Provider Rights and Responsibilities: visit Provider Tools
• For Hospital Admit, Prescribe Plan, Practitioner or Organizational Provider Application: visit  Forms

ReCredentialing - ensuring the ongoing integrity of the IPN network 

Recredentialing is the review process for determining the continued eligibility of an IPN participating provider. Providers are required to recredential, a least, every 36 months. A recredentialing application is sent to the provider at least thirty days prior to the expiration of the last credentialing date. The application must be completed and submitted to IPN before the expiration date along with all supporting documentation. Failure to comply with the recredentialing requirement may result in immediate termination as an approved IPN network provider. 

• See the list of providers who received Approved ReCredentialing since the beginning of 2022. NOTE: This list does not guarantee participation with all service locations. For service location details, contact IPN.