[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-327802-105":59,"doc-detail-327802-en":135},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":128,"head_meta":130,"extra_data":132,"updated_unix":134},105,"en","adding-a-new-provider-to-an-existing-practicetax-id-request-optima-health-credentialing","Adding a New Provider to an Existing Practice/Tax ID - Request Optima Health Credentialing","","Instructions for adding a new healthcare provider to an existing Optima Health practice by initiating the practitioner credentialing process. The guidance explains when to submit the Provider Update form, emphasizing that the practice tax ID must already be in network; otherwise, network participation requests are handled through a separate form. It details required steps and eligibility checks, including maintaining a current CAQH application and completing the online Provider Update form. It lists specific CAQH attestations, required credentialing data, and supporting attachments such as malpractice history and CV/resume, plus contact help.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/adding-a-new-provider-to-an-existing-practicetax-id-request-optima-health-credentialing/327802/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/adding-a-new-provider-to-an-existing-practicetax-id-request-optima-health-credentialing/327802.png","ImageObject",300,407,{"name":92,"@type":93},"Ethan Miller","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-26","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"When should a practice submit the Provider Update form for a new provider?","Question",{"text":113,"@type":114},"Submit the Provider Update form only when the new provider is not already credentialed with Optima Health and the practice tax ID is already in network. Submitting initiates the Optima Health practitioner credentialing process.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does Optima Health credential providers and what must be ready before submitting?",{"text":118,"@type":114},"Optima Health uses the Council for Affordable Quality Healthcare (CAQH) application for credentialing. Ensure the provider has an active CAQH application and that the CAQH attestation is current (attested within the last 120 days).",{"name":120,"@type":111,"acceptedAnswer":121},"What information and attachments are required in the CAQH application?",{"text":122,"@type":114},"The CAQH application must include items such as board certification/date for boards, all past and current state licenses and DEA information, explanations for malpractice suits and gaps in malpractice insurance, education history, work history for the past 10 years, explanations for work history gaps over 6 months, professional references, and other listed details. Supporting attachments include a CV/resume and malpractice history (with different lengths for midlevel providers), plus nursing board certificate when applicable.",{"name":124,"@type":111,"acceptedAnswer":125},"What should a practice do if its tax ID is not currently in network with Optima Health?",{"text":126,"@type":114},"Do not submit a Provider Update form. To request network participation/contract, complete the “Request for Participation” form available on Optima Health’s Join our Network page.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},327802,1790231034,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":81},687207017582,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Adding a New Provider to an Existing Practice/Tax ID  \nIf your new provider is not already credentialed with Optima Health, submitting the Provider Update form will initiate the Optima Health practitioner credentialing process. Optima Health utilizes the Council for Affordable Quality Healthcare (CAQH) application for credentialing. Please ensure the provider has an active CAQH application prior to submitting this request.  \nIf your practice (tax ID) is currently not in network with Optima Health, please DO NOT submit a Provider Update form. To request network participation/contract, please complete the “Request for Participation”[form available at Join our Network on](form available at Join our Network on www.optimahealth.com/providers)[ ](form available at Join our Network on www.optimahealth.com/providers)[www.optimahealth.com/providers](form available at Join our Network on www.optimahealth.com/providers).  \nPlease follow the steps below for submission:  \n1. Ensure the practitioner’s Council for Affordable Quality Healthcare (CAQH) application is complete and up to date. Please see CAQH requirements below. Please adhere to these requirements; omitting required fields or required attachments will cause your request to be returned to you for correction and will delay the new provider credentialing process.  \n2. Complete and submit the online Provider Update Form on the Update Your Information [page on](page on www.optimahealth.com/providers)[ ](page on www.optimahealth.com/providers)[www.optimahealth.com/providers](page on www.optimahealth.com/providers).  \nOptima Health requires the CAQH application contain the following information:  \n􀀹 CAQH attestation must be current. CAQH applications that have not been attested within 120 days will not be accepted.  \n􀀹 Board Certification information or date when taking boards  \n􀀹 All past and current state licenses and DEA information  \n􀀹 Explanation for any malpractice suits  \n􀀹 Explanation for gaps in malpractice insurance  \n􀀹 Education history, including applicable internship/residency/fellowships  \n􀀹 Work history for past 10 years  \n􀀹 Explanation of any work history gaps greater than 6 months  \n􀀹 Professional references from 2 providers with contact phone numbers  \n􀀹 Covering colleagues or partners/associates  \n􀀹 Foreign languages spoken  \n􀀹 Listing of hospital privileges (if applicable)  \n􀀹 ECFMG number (if applicable)  \nThe following must also be attached in CAQH:  \n􀀹 Copy of Curriculum Vitae or Resume in month and year format  \n􀀹 7 years of malpractice history (2 years for midlevel providers)  \n􀀹 Copy of the Nursing Board Certificate (ANCC, AANP, NCC, PNCB) when applicable  \nFor assistance with a CAQH application, please contact the CAQH Provider Help Desk (1-888-599-1771 [or](or providerhelp@ProView.CAQH.org)[ ](or providerhelp@ProView.CAQH.org)[providerhelp@ProView.CAQH.org](or providerhelp@ProView.CAQH.org)).","cbCaim9Ho6KOgnE2","https://ap.wps.com/l/cbCaim9Ho6KOgnE2","pdf",203283,"English","# Provider update vs network participation\n## When to submit the Provider Update form\n## When to request network participation\n# Submission steps\n## Step 1: Prepare CAQH information\n## Step 2: Complete the Provider Update form\n# Required CAQH information and attachments\n## CAQH attestation and credentialing details\n## Supporting documents","[{\"question\":\"When should a practice submit the Provider Update form for a new provider?\",\"answer\":\"Submit the Provider Update form only when the new provider is not already credentialed with Optima Health and the practice tax ID is already in network. Submitting initiates the Optima Health practitioner credentialing process.\"},{\"question\":\"How does Optima Health credential providers and what must be ready before submitting?\",\"answer\":\"Optima Health uses the Council for Affordable Quality Healthcare (CAQH) application for credentialing. Ensure the provider has an active CAQH application and that the CAQH attestation is current (attested within the last 120 days).\"},{\"question\":\"What information and attachments are required in the CAQH application?\",\"answer\":\"The CAQH application must include items such as board certification/date for boards, all past and current state licenses and DEA information, explanations for malpractice suits and gaps in malpractice insurance, education history, work history for the past 10 years, explanations for work history gaps over 6 months, professional references, and other listed details. Supporting attachments include a CV/resume and malpractice history (with different lengths for midlevel providers), plus nursing board certificate when applicable.\"},{\"question\":\"What should a practice do if its tax ID is not currently in network with Optima Health?\",\"answer\":\"Do not submit a Provider Update form. To request network participation/contract, complete the “Request for Participation” form available on Optima Health’s Join our Network page.\"}]","Adding a New Provider to an Existing Practice/Tax ID - Request Optima Health Credentialing | PDF",1789978090]