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Credentialing and Recredentialing

Join the CIGNA HealthCare network

You must meet our standard credentialing criteria to become a provider in a CIGNA HealthCare network. Recredentialing is required every three years in most states. The recredentialing process requires you to meet the same criteria as you did during the initial credentialing process.

Here are our credentialing criteria:

  • signed application and agreement (see below)
  • verification of unrestricted state medical license with appropriate licensing agency
  • verification of valid, unrestricted DEA certificate
  • verification of full, unrestricted admitting privileges and good standing on the medical staff at a CIGNA-participating hospital
  • board certification status with the American Board of Medical Specialties
  • review of malpractice claims history
  • verification of education and training
  • review of work history
  • verification of adequate malpractice insurance
  • on-site visit to PCPs, OB/GYNs and high-volume behavioral health specialists
  • verification of prior sanctioning activities
  • proof of appropriate professional licensing (only for practitioners whose professions do not require medical licensure)

You may be able to submit an application and agreement using the Council for Affordable Quality Health Care (CAQH) Universal Credentialing DataSource application at www.caqh.org. Please contact your Provider Relations representative first to ask about our need for additional providers in your specialty.

Once we verify all your credentialing information, we'll present it to the health plan credentialing committee. This committee is composed of community physicians for peer review, and the health plan medical director. If you're accepted for participation in our network, you'll receive a "welcome" letter within 60 days of the date of the decision, or sooner, if required by state law.
     
See how the CAQH universal credentialing tool(PDF) can make the credentialing process easier and more cost-effective.