In Addition to the Credentialing processes provided, the following items are specific to the Colorado Provider Application/Credentialing Process:

• Within seven (7) calendar days after Humana receives an application, Humana shall provide the applicant a receipt in written or electronic form.
• Upon receiving an application, a carrier shall promptly determine whether the application is complete. If the carrier determines that the application is incomplete, the carrier shall notify the applicant in writing or by electronic means that the application is incomplete within ten (10) calendar days. The notice that is sent must describe the items that are required to complete the application.
• If Humana receives a completed applications but fails to provide the applicant a receipt in written or electronic form within seven (7) calendar days of receipt, Humana shall consider the applicant a participating physician, effective no later than fifty-three (53) calendar days after receipt of the application.

Important credentialing update for WI, CO, and MA

Humana is entering into a multi-payer credentialing solution in partnership with Elevance and Sutherland Healthcare Solutions. This initiative aims to streamline the recredentialing process, enhance efficiency and reduce administrative burdens for our providers.

Pilot regions: This program will initially launch as a pilot in Wisconsin, Colorado and Massachusetts.

Action required: Please ensure your CAQH profiles are up-to-date and authorized for information sharing across plans. Your earliest recredentialing date will determine the start of this consolidated process. Once your recredentialing is complete, your file will be shared with all affiliated health plans, standardizing your recredentialing date across these organizations.