Organizational provider credentialing and screening
The organization types listed below must be credentialed or screened prior to seeing Priority Health plan members - this includes completing the requirements listed below and receiving our approval. If you don't see your organization type listed below, you're considered a "standard provider group" with us and don't require an organization application.
Organizations that require credentialing or screening
The organizational providers listed below are required to complete our credentialing and screening process before accepting Priority Health patients seeking in-network services. This is the full list of practitioners that require a prism application.
Most credentialed organizations don't need credentialing for individual practitioners. Review our credentialing criteria by provider type to determine if we require your practitioners to complete individual provider applications to become in-network.
Credentialed organization types
- Acute Rehab Facilities
- Behavioral health facilities
- Freestanding ambulatory surgery Facilities (ASF)
- Sleep disorder clinics
- Community-based health centers
- ESRD providers
- Federally qualified health centers
- Home health care
- Home infusion
- Long-term acute care
- Rehab facilities (PT, OT, ST)
- Retail health clinics
- Rural health clinics
- School-based health clinics
- Skilled nursing facilities (SNF)
- Tribal health clinics
- Urgent care facilities
Non-credentialed (screened) organization types
- Audiology (hearing screenings, hearing aid suppliers)
- Diabetic prevention program
- Durable medical equipment (DME)
- Emergency medicine
- Health department
- Independent diagnostic service
- Radiology/imaging center
Credentialing and screening process
We use an automated submission process for our credentialing form. Learn more about this process by reviewing these prism materials.
To credential your organization:
- Log in to your prism account (Don't have an account? Register here.)
- Click Enrollments & Changes
- Click New Organizational Provider Enrollment and follow the steps as indicated
Note: For credentialed organizations, this application must include current accreditation and current professional and general liability insurance coverage. If you don't have a contract on file, a contracting team member will reach out to secure a contract.
- Include a completed IRS form W-9, Taxpayer Identification and Number Certification.