MultiPlan credentialing is the process by which the credentials and background information of a provider, including education, licenses, employment, and qualifications, are authenticated to be part of the MultiPlan provider network. This ensures the required credentials are met before allowing a provider to render services to MultiPlan members. Once credentialed and contractually linked, they may benefit from certain negotiated reimbursement rates.
If you have seen the MultiPlan or PHCS logo on patient insurance cards, you’re probably wondering about the MultiPlan credentialing process. It is natural to be curious about the method to join this network.
But before talking about the MultiPlan provider credentialing, let’s review the organization itself. MultiPlan is not an insurance company. Rather, it is a Preferred Provider Organization (PPO) network run by Claritev Corporation (which MultiPlan’s parent company changed to in 2025).
Health plans, self-insured employers, and third-party administrators lease the network. Meaning, these payers process and pay the claims, not Claritev. Claritev’s clientele includes insurance carriers, self-insured employers, labor management plans, and government agencies.
A Step-by-Step Guide to MultiPlan Credentialing Application
MultiPlan’s credentialing process, managed by Claritev, is less detailed than most providers assume. Here’s what it includes, in order of when you will probably encounter it.
Begin a Nomination Request
Claritev directs providers to its “Join Our Network” feature on its official website. All submissions via the web-based portal can be tracked through the provider nominations page.
Select the Form Based On Your State
Providers in 19 states and the District of Columbia can submit the state standard credentialing form rather than the Claritev one, for both initial credentialing and re-credentialing. The 19 states include Arizona, Illinois, Ohio, Texas, and several others.
Claritev provides the forms on its provider support page, although not all states have a re-credentialing version.
Submit a Signed Contract
Among the MultiPlan credentialing requirements, contract signing is where most people go wrong. The state form needs to be accompanied by the completed and signed Claritev provider contract. So, sending a state form by itself isn’t considered an application.
Register for the Provider Portal
The provider portal is completely free to access for all applicants according to Claritev. Claritev further explains that the portal enables applicants to check MultiPlan credentialing application status and requests.
They may also confirm participation, request fee schedules, contracts, rosters, and update demographic information via the portal.
Address Profile Discrepancies & Verification
Claritev will inform you about discrepancies found in your profile and give you an opportunity to fix them. The rectification can be done during verification or via the appeal process described in its Network Handbook.
Verify Participation Before Charging
MultiPlan insurance credentialing applicants should verify their network participation by checking their profiles on the portal. Assuming an approved participation status can lead to billing errors and financial burdens that practices must absorb.
MultiPlan Provider Credentialing Requirements
Claritev does not have a master MultiPlan credentialing document checklist on their page for the public provider. But the application or state form is a guide for the requirements list.
Generally, most MultiPlan payer credentialing applications require an active state license and a National Provider Identifier (NPI) number. Secondly, proof of malpractice insurance, education and training history, employment history, and board certifications may be required.
Even though there is no official requirements list, some Claritev-specific rules would be helpful to know:
Groups
Any changes in the roster of providers that are under the group must be submitted by the group administrator. The administrator will specify if it is a change or a whole new roster.
Rights
Practitioners may inquire regarding their credentialing information collected by the network (excluding information that is protected by peer review). Healthcare providers can place a request via the provider portal.
Government Programs
Claritev maintains dedicated support pages for Medicare Advantage and Medicaid. It also has pages for several networks, including the MultiPlan Medicare Advantage Network and the PHCS Medicaid Network.
In addition, prescribers may need DEA and controlled substance registration for MultiPlan credentialing.
Challenges in Getting Credentialed with MultiPlan
Credentialing with MultiPlan poses some serious challenges that applicants must know. These include:
No Specific Timeline
There’s no timeline on how long the MultiPlan credentialing process may take. Any data found elsewhere will only serve as an estimate. So, applicants should contact the Service Operations Department at 1-800-950-7040 and track their applications through the provider portal.
Limited Tools
Nominations show the status of your application within Claritev’s online system only. Applicants can know the status of their file, but not what’s preventing it from moving to the next step. To know that, applicants must reach out to the payer or visit the portal.
PHCS Network vs. MultiPlan Network
Claritev describes the PHCS Network as a primary national network and the MultiPlan Network as a complementary national network. But which of the two applies to a specific member impacts the entire process.
Claims Are Not Submitted To Claritev
Claims are submitted at the remittance address mentioned on the patient’s identification card and not Claritev. Conversely, for electronic claims, the identification card indicates the clearinghouse payer ID.
Claritev states that payments will be made within 30 business days after claim submission to the payer. Any payment issue is handled by the payer indicated on the identification card/EOB, whereas contract or network issues are handled by Claritev.
Benefit Inquiry
Claritev does not handle benefit inquiries. Benefit inquiries should be directed to the phone number indicated on the back of the identification card.
Best Practices for MultiPlan Insurance Credentialing
Applicants can adopt the following best practices to mitigate MultiPlan credentialing challenges:
Submit the Complete Package
The signed contract is the most common missing credentialing information. So submit that with your MultiPlan credentialing form.
Maintain Information Consistency
Your National Plan and Provider Enumeration System (NPPES) listing, Council for Affordable Quality Healthcare (CAQH) ProView profile, and application should all have the same address and information. The Claritev site does not mention CAQH, but many payers use it as their source of truth, and inconsistency leads to delays.
Ensure Early Portal Registration
Register on the MultiPlan portal early to check your status, get your fee schedule, and view your contract.
Do Follow-ups On A Schedule
When a file stops responding, do not let it sit for too long. Address the issue promptly because Claritev claims that escalations are resolved within less than five business days on average.
Maintain Accurate Demographics
Out-of-date information hinders claims filing and the patient directory. Claritev calls phone companies to verify your demographic information, including tax ID and service address. So, ensure all information is correct. In case of any changes, contact Claritev immediately.
Verify Eligibility On-Site
Claritev suggests confirming eligibility and authorizations using the number provided on the member ID card and collecting co-pays and deductibles on-site.
If following all of this advice feels too challenging, third-party medical credentialing services may also be a good option.
In A Nutshell
MultiPlan credentialing or Claritev enrollment is a multi-step process that requires accuracy, filing the right data, and applying for it according to the guidelines set out in this article. However, credentialing with MultiPlan can be quite tedious for many applicants. Fortunately, with MediBillMD’s help, the process becomes smooth, and applicants rarely face any hiccups.
