Credentialing
WVP CREDENTIALING TEAM
The WVP Credentialing Team includes two (2) Credentialing Specialists and one (1) Credentialing Manager. The Credentialing Team performs all credentialing and re-credentialing services in accordance with CMS, NCQA, and URAC guidelines.
The WVP Credentialing Team Lead is certified by the National Association Medical Staff Services (NAMSS) as a Certified Professional Credentialing Specialist (CPCS) and Certified Professional Medical Services Management (CPMSM) and provides many years of experience with the provider community and is knowledgeable in credentialing for the IPA, Medical Group Practices, and delegation arrangements.
The WVP Credentialing Team is available to provide practice support for credentialing as well as payer support in the form of delegation arrangements. The WVP Credentialing Team is also available to provide credentialing services for individual providers and/or clinics.
For Providers:
- WVP is always open to providers who are interested in being a new member with WVP and who align with our mission.
- Credentialing with WVP is required for membership and contract participation. When you are credentialed with WVP, you are credentialed with any payer who has delegated credentialing to WVP. (See the table below for included payers.) WVP is always looking to add more payers to our delegated credentialing to make the credentialing process easier for our members. We will be updating this list soon.
- WVP strives to process applications as quickly as possible, within 30-45 days of receipt of an application. It is important that when submitting an application all required documentation is submitted and all forms are complete. Your prompt response to any requests for additional information ensures that we are able to process your application quickly.
- The WVP Credentialing Team is available to provide practice support throughout the entire credentialing process and after credentialing has been completed with WVP.
- The WVP Credentialing Team is also available to help provide guidance on the steps for credentialing/enrollment with other payers, Oregon Medicaid, and Medicare.
- The WVP Credentialing Team also offers Credentialing Services to clinics and providers who are looking for someone to manage their credentialing with contracted payers. Please contact the Credentialing Team for more information.
- Here is a
Credentialing Guide for providers.
- You can reach the Credentialing Team at credentialing@mvipa.org or 503-587-5113.
For Payers
- WVP maintains clearly defined written policies and procedures that align with CMS, NCQA, URAC, and contracted payers.
- The WVP Credentialing Team actively maintains rosters with contracted payers on a monthly and quarterly basis.
- WVP is available for Delegated Credentialing Arrangements with payers. If your plan is looking to a delegate credentialing to a well- established network of providers, please contact the Credentialing Team for more information.
- You can reach the Credentialing Team at credentialing@mvipa.org or 503-587-5113.
Credentialing Applications
List of Services
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IPA Credentialing Reference Tool
| Payer | LOB | Credentialing Entity | Covered Providers | Exceptions |
| AgeRight | MA Plan | Delegated: IPA | All Medicare Eligible Providers | Hospital based provider credentialing not required |
| Atrio | MA Plan | Delegated: IPA | All Medicare Eligible Providers | Hospital based provider credentialing not required |
| HealthNet | All LOB- Commercial, Medicaid, Medicare | Delegated: IPA | All fully licensed medical providers | All BH: credential through MHN |
| Providence Health Plans | PEBB and MA | Direct with Payer | ||
| Majoris | Worker's Comp | Delegated: IPA | NA | |
| PacificSource | All LOB- Commercial, Medicaid, Medicare, D-SNP | Delegated: IPA | All fully licensed providers | Hospital based provider credentialing not required |
| Updated 03/2024 |