Curious about how long Humana’s credentialing process takes and how to join its network? This blog can be your ultimate guide! Humana is a private, Louisville-based health insurance company offering a wide range of products and services. With over 14.8 million medical members in 2025, the insurer offers significant growth opportunities for healthcare providers. The only thing standing in your way? Uncertainty!
Thousands of medical professionals face credentialing delays due to errors in the application. As a result, healthcare organizations lose thousands of dollars per provider each day. Don’t want to face the same problem? Let us provide a step-by-step guide on how you can get credentialed with Humana.
A Step-by-Step Guide to Humana Credentialing Application
You get two main advantages by joining Humana’s network:
- A chance to grow your practice
- Access to dedicated support
So, what are the steps to become an in-network provider with this insurer? While the overall process is mostly similar, there are slight variations for medical, dental, and behavioral health providers. Here is a detailed breakdown of Humana’s credentialing application.
Step 1: Request to Join
The initial step to joining Humana’s network is quite simple. You have to submit a request for participation. You can do that by going to Humana’s ‘Join Our Network’ page. The method, however, varies from state to state and the type of providers.
Medical Providers
Medicare and Medicaid providers in the following states can show their interest by submitting the payer’s online form.
- Indiana
- Kentucky
- Michigan
- Ohio
- Oklahoma
- Virginia
- West Virginia
However, if you are in any other state, you will need to email the Letter of Interest Request to your Humana regional representative.
Behavioral Health Providers
If you are a behavioral health provider, you can connect with Humana’s Behavioral Health Network team. Simply, complete and submit its online request form if your practice is in one of the following states:
- Indiana
- Michigan
- Ohio
- Oklahoma
- Virginia
- West Virginia
Otherwise, you must submit the Behavioral Health Provider Inquiry form.
Dental Providers
Dentists, on the other hand, also have to fill out a different form. If you are interested in joining Humana’s dental network, submit your request for participation through this form. The payer will ask you to provide details about your practice.
Step 2: Look Out for Humana’s Email
After submitting your request for participation, watch out for Humana’s email. The payer will send an email with the appropriate follow-up steps.
Medical Providers
After validating your information, Humana will send an email inviting you to complete your request to join its network in the Quickbase app. Follow the provided instructions and submit an appropriate specialty-specific form.
Behavioral Health Providers
On the other hand, behavioral providers will receive an email with contracting documents to complete.
Dental Providers
If you are a dentist, you can expect Humana to send a participation agreement within 2 business days of submitting the online form.
Step 3: Complete Your Application
The next step is to complete Humana’s provider credentialing application. Humana primarily uses the Council for Affordable Quality Healthcare (CAQH) ProView for provider credentialing. However, it may require you to fill out an online application in some cases.
Medical Providers
After completing your specialty-specific form, Humana will ask for additional details about your practice. You can provide this information, including the networks you wish to join, by selecting ‘New Provider Request’ in the Quickbase app and filling out the questionnaire. Then, upload the required documents and submit your application.
Humana may request access to your CAQH profile. So, make sure to update it before providing your credentials.
Behavioral Health Providers
If you are a behavioral health provider, you will need to update your CAQH profile to complete the application process. Make sure your profile is updated. In simple terms? You must upload the most recent documentation, including licenses and certifications. Keep one thing in mind! Humana’s credentialing process for behavioral health providers typically takes 60 to 90 days.
Dental Providers
As per the instructions, complete the CAQH registration before your agreement is effective to obtain an ID. Create a profile for a smooth process. But if you already have it, update it to avoid credentialing issues.
Step 4: Track Your Application Status
Tracking your Humana credentialing application status is important to avoid delays and surprises. So, how can you keep an eye on your application status?
Medical Providers
Once you submit the application, Humana will send an email with a tracking number. Log in to Humana’s online portal or call 1-800-626-2741 to inquire about the status of your application.
Behavioral Health Providers
If you are a behavioral health provider, including a psychiatrist, social worker, or psychologist, you can check your Humana credentialing application status by logging into Availity.
Dental Providers
Dental providers, on the other hand, can check their credentialing status by emailing Humana’s credentialing department at dentalcredentialing@humana.com.
Step 5: Finalize Contract
Once you get a confirmation email, the last step is to negotiate your contract. After your contract is finalized, Humana will send an effective date along with a welcome packet.
Humana Provider Credentialing Requirements
Humana’s credentialing requirements are quite simple for all providers. The following table describes what you need to upload or provide to get credentialed:
| Key Requirements | Details |
|---|---|
| CAQH Profile | You must have an active CAQH ProView profile. |
| Practice Locations | All applicants must provide information about current and prior practice locations. |
| Identification Numbers | Your application must include:Social Security Number (SSN)National Provider Identity (NPI)Drug Enforcement Administration (DEA) NumberUnique Provider IDProfessional License Number |
| Attestation Form | Must be dated and signed |
| Curriculum Vitae (CV) | Upload the latest CV with relevant work history in a month/year format. |
| Professional License | Your profile must also have valid and active professional license(s). |
| DEA Registration | You must also have a valid and unrestricted DEA certificate (if applicable). |
| CDS Certificate | Also, upload Controlled Dangerous Substances (CDS) certificate (if applicable). |
| Malpractice Insurance | Provide a copy of your malpractice insurance face sheet. |
| Malpractice History | Don’t forget to include a summary of pending or settled malpractice claims. |
| W-9 Form | Humana may also require a W-9 form matching your Tax Identification Number (TIN) in PDF format. |
Important Note: You don’t have to provide your CAQH ProView profile’s access to Humana if you are a provider in Arkansas. Simply, contact your state medical board for Humana’s credentialing procedure.
Challenges in Getting Credentialed with Humana
So, what challenges do most providers face when getting credentialed with Humana? Here are the most common pain points:
Scattered or Unclear Credentialing Instructions
Scattered information is one of the biggest challenges when applying for Humana’s network. Which form should you fill out? Which email address should you use for questions? The instructions are spread across different webpages, with medical, dental, and behavioral health providers each required to submit different forms of interest.
As a result, many providers, especially first-time applicants, submit an incorrect form or miss key details, leading to frustration and delays.
Complex Regional Structure
This is another major challenge! Humana’s credentialing process depends on your practicing state. In simple terms? The process is not uniform across all locations. As a result, healthcare providers must choose between the following two options, depending on their location:
- Completing the request-to-join form themselves
- Sending a Letter of Interest to a regional representative
While this regional structure helps Humana manage applications more efficiently, it adds another layer of complexity for providers, often leading to mistakes and confusion.
Credentialing Delays & Denials
Humana typically takes 60 to 90 days to process an application. However, the confusion caused by the challenges above often leads to incomplete or inaccurate applications. This results in exactly what providers want to avoid: longer processing times, delays in some cases, and outright denials in others.
Best Practices for Humana Insurance Credentialing
Does Humana’s credentialing process feel overwhelming? It doesn’t have to be! You can minimize delays and avoid outright denials by following these best practices:
Understand Regional Requirements
As you might have already gathered, Humana’s provider credentialing varies by state. Our advice: take your time to understand its regional requirements. The payer has provided clear details on its Join Our Network page.
Before starting the credentialing process, determine whether you can submit an online form or must send a Letter of Interest to your local representative. You can find the email address for your regional representative here or here.
Verify Credentialing Instructions
Don’t rush the process! Before expressing interest in credentialing with Humana, carefully review the instructions on its website. Explore the relevant network page (medical, dental, and behavioral health network) to find the correct form and contact details. This approach can save you from weeks of delays.
Frequently Update Your CAQH Profile
As we have mentioned multiple times, it is mandatory for all providers interested in Humana’s network to have a CAQH ProView profile. Make sure your profile includes your current, valid licenses, work history, malpractice coverage, and claims. Remember to re-attest your information every three months.
Actively Track Your Application
The best way to avoid miscommunication and delays is to actively monitor the progress of your application. Log in to Availity or directly email Humana’s credentialing department to check the status of your application.
MediBillMD Makes Credentialing Easy
Let’s be realistic! Provider credentialing is a frustrating and time-consuming process, especially for first-time applicants. That’s where certified credentialing experts, like MediBillMD, come in. So, if you still feel overwhelmed, leave it all to us.
At MediBillMD, we take a proactive approach to submitting and tracking your credentialing application. Our experts understand and efficiently manage Humana’s credentialing requirements, ensuring a smooth onboarding process. We provide customized solutions depending on your goals and contracting history.
Our insurance credentialing services include everything, from gathering relevant documentation and updating your CAQH profile to validating your history and submitting your application through appropriate channels. So, focus on your patients and let us take care of your paperwork.
