The healthcare industry continues to grow, and as more providers join the industry, they seek participation in Medicare Advantage networks for smoother reimbursements. That’s when Devoted Health credentialing becomes an important consideration. Devoted Health was founded in 2017 by Todd and Ed Park. Today, it operates as a Medicare Advantage-focused health plan serving members in 29 states. Their stated mission is to provide better healthcare for older Americans.
For healthcare providers, enrolling in the Devoted Health network involves two major steps:
- Network participation and contracting
- Completion of the required credentialing process
Devoted Health provider credentialing may appear straightforward, but successful enrollment depends on accurate documentation and completion of payer-specific requirements. But knowing how these steps connect and the common gaps can be the difference between a smooth onboarding and weeks of avoidable delay.
Interestingly, Devoted Health claims that more than 90% of its providers are credentialed within 3 weeks after a complete application is submitted. However, actual timelines may vary depending on the completeness of the provider’s application, supporting documentation, and response to the primary source verification.
A Step-by-Step Guide to Devoted Health Credentialing Application
Applicants may encounter delays in Devoted Health provider credentialing when they are unfamiliar with the application process or submit incomplete information. When completing a Devoted Health credentialing application, providers should generally work through the following steps:
1. Network Participation Request Submission
Providers who have not been credentialed with Devoted Health must visit the “Joining Our Network” page rather than the credentialing portal. Participation requests are typically reviewed individually based on the network’s needs.
Providers should allow 30-60 days for their participation request to be evaluated. If Devoted Health confirms a need in the provider’s particular specialty or area, the provider will be contacted by a team member to discuss contracting.
If an applicant does not receive a response, it may indicate that Devoted Health is currently not accepting additional providers in that specialty or service area.
However, the applicant’s information is stored in the system for future network needs. Please note that completing this participation request does not itself constitute a Devoted Health credentialing application.
2. Credentialing Execution
Contracting and credentialing are separate steps in the network participation process. Credentialing requirements are completed as part of Devoted Health’s provider onboarding process. Providers should follow Devoted Health’s instructions for submitting credentialing information.
3. CAQH ProView Profile Maintenance
Devoted Health uses CAQH ProView information as part of its credentialing process. Therefore, providers must ensure that Devoted Health can access their current CAQH profile. The profile should also include complete and up-to-date information to help prevent credentialing delays.
4. Facility Information Submission (For Groups)
Once a healthcare group has completed its Devoted Health contracting process, it can use the applicable credentialing workflow in Availity under the Devoted Health payer space. Groups can use it to submit facility credentialing information. Instructions are included in the application.
5. Follow-up Request Responses
Devoted Health’s credentialing team may contact the provider if information is incomplete, outdated, or requires clarification. Therefore, busy providers must maintain a responsive and designated credentialing contact that can help prevent delays in the credentialing and enrollment process.
6. Credentialing Committee Approval
Before a provider begins rendering services or submitting claims under the Devoted Health network, he must meet the applicable Devoted Health insurance credentialing, contracting, and effective-date requirements.
Similarly, primary care providers may need to complete credentialing and receive network approval before members can be assigned to them, where applicable.
7. Effective Date Confirmation
Once the Devoted Health credentialing application status becomes “Approved”, the provider or group’s credentialing contact is notified by email. Applicants can then review the effective dates through the Devoted Provider Portal via Availity login. Providers who do not have active Availity access can contact 1-877-762-3515.
Availability:
- October to March: 8 am to 8 pm, 7 days a week.
- April to September: 8 am to 8 pm, Monday to Friday, and 8 am to 5 pm, Saturday.
Devoted Health Provider Credentialing Requirements
The Devoted Health credentialing forms and process may vary across specialties and designations. For instance, credentialing may not be needed for:
- Mid-level providers working under direct supervision of another practitioner.
- Hospital-based healthcare professionals who provide incident-to services.
Moreover, Devoted Health lists required and exempted provider types in its Provider Credentialing FAQs. Providers who must credential must provide:
- An attested and active CAQH ProView profile and authorized Devoted Health to access and review it.
- An executed contract with confirmed roster placement.
- Complete and current facility and practitioner information submitted through Availity.
- A designated credentialing contact available to respond promptly to Credentials Verification Organization (CVO) inquiries.
Special Consideration
If a speciality involves covering absences, providers should know Devoted Health’s continuity-of-care rule:
A Primary Care Physician (PCP) planning 90 consecutive days or more of absence must notify Devoted two weeks in advance via contact information available.
The notification must include the:
- Dates of absence
- Covering provider’s information
- A credentialed, in-network provider as a substitute provider
Challenges in Getting Credentialed with Devoted Health
Devoted Health credentialing and enrollment can be challenging because several friction points recur in the process. These may include:
- Providers may submit documentation before a contract is finalized, which can stall their progress with zero forward movement.
- A lapsed attestation or missing authorization can trigger outreach cycles that extend the total process time.
- Providers without Availity access have no self-service method to verify effective dates. Therefore, they must contact Provider Services directly.
- Providers in saturated specialties or areas may not get a response from Devoted Health at all. However, the provider information may be used for future reconsideration.
- Missing or inaccurate roster information delays processing.
Best Practices for Devoted Health Insurance Credentialing
Enrollment and credentialing with Devoted Health can often result in delays and rejection if you don’t take the right approach. Therefore, here are some best practices to help you:
- Ensure the Data Spring (formerly CAQH ProView) profile is updated and accessible by Devoted Health before initiating the credentialing process.
- Provide one responsive credentialing contact to reduce back-and-forth when additional documentation is requested.
- Treat contracting and credentialing as individual steps, and do not begin credentialing until the contract is signed.
- Sign up for Availity before beginning so you can track the application status within effective dates without phone call follow-up.
- Remember, participation requests may take 30-60 days to evaluate, and additional credentialing steps will follow.
In a Nutshell
Devoted Health provider credentialing is a step-by-step process, and each step has its weight. Credentialing and enrollment errors can easily consume staff time that may be spent on patient care.
If your practice doesn’t manage CAQH attestations, roster submissions, and CVO correspondence, MediBillMD’s insurance credentialing services ensure that all these steps are handled with care.
