Credentialing

Independent Care Health Plan only credentials provider organizations and their affiliated practitioners after the Network Development Team has reviewed the Provider Application and decided to move forward with the contracting process. iCare's Credentialing Department will review your application and may also contact you with additional information requests or questions.

If your organization has practitioners that require credentialing or if you are an individual solo-practice, an application and return envelope will be mailed to you from Rural Wisconsin Health Cooperative, iCare's contracted credentials verification organization.

Minimum Individual Provider Credentialing Criteria

1. A current valid, unrestricted Wisconsin license or certification if licensure is not available
2. Wisconsin Medicaid certification
3. Medicare Certification (if applicable)
4. Current professional liability insurance adequately meeting minimum state requirements as defined by State of Wisconsin Statute and Administrative Code relating to practice of Medicine (See Wis. Stats. §655.23)
5. Completed appropriate education and training for applied specialty
6. Acceptable malpractice liability claims history
7. Sanction-free status by federal and state regulatory authorities
8. 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
9. Current Attestation and Authorization for Release of Information

Additional Criteria For Physicians:

1. A current valid unrestricted Drug Enforcement Administration (DEA) certificate, if applicable to profession
2. Current unrestricted admitting privileges at an iCare 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 iCare provider or facility
3. Evidence of 24 hours per day, 7 day per week professional coverage arrangements