Requirements For Network Participation
A physician or facility must be credentialed and approved before they can be added to the MedCost network. They also must follow an approval process for recredentialing every three years to remain in the network. The MedCost credentialing program has been accredited by URAC since 2000, which assures our clients and members of our compliance to federal and state credentialing standards.
Streamlined (Re)Credentialing Through CAQH
To eliminate the need for physicians and other health care providers to submit multiple (re)credentialing applications, MedCost participates in the Council for Affordable Quality Healthcare (CAQH). Their Universal Provider Datasource® enables a physician or health care provider to submit a single standard application that is designed to meet the needs of all organizations involved in the (re)credentialing process. And, there is no cost for physicians and other health care providers to submit information.You easily can update your information at any time, and you will be asked to verify the accuracy of the information quarterly.
If you would like for MedCost to access your credentials through the CAQH service, click here. Please include your name, specialty, and CAQH ID in the body of the e-mail.
To learn more about CAQH, visit their Web site at www.CAQH.org.
Initial Credentialing Applications For Download
If you do not participate with CAQH, MedCost accepts traditional credentialing applications. Choose the appropriate link below to download and print an application.
Physician Initial Credentialing –North Carolina (and Physicians outside of North or South Carolina)
Physician Initial Credentialing – South Carolina
Facility Initial Credentialing – Any Location
Recredentialing Applications For Download
MedCost recredentials our participating providers and facilities every three years as required by URAC. If you participate with CAQH, please see the section above on “Streamlined (re)credentialing through CAQH” and submit your CAQH ID using the e-mail link shown. If you do not participate with CAQH, please choose the appropriate link from the list below to download and print are credentialing application.
Physician Recredentialing – Any Location
Facility Recredentialing – Any Location
Submitting Applications
Return your completed (re)credentialing application(s) and attachments to:
E-mail: credentialingapps@medcost.com
Fax: (336) 970-2139 Attn: Credentialing Department
Mail: MedCost, LLC
Attn: Credentialing Department
P.O. Box 25347
Winston-Salem, NC 27114-5347
Helpful Tips - Provider Applications
To avoid any processing delays, include the following materials as part of your provider (re)credentialing application:
- Completed application with current date and signature
- Copy of your state license
- Copy of the face sheet of your current professional liability insurance policy, indicating the name of the practice, name of the covered provider, coverage amount(s), effective date, expiration date, and policy number
- Copy of certificate from Specialty Board
- Copy of Curriculum Vitae or work history
- Explanation for all “Yes” responses on“Professional Information” section of application
Helpful Tips - Facility Applications
To avoid any processing delays, include the following materials as part of your facility (re)credentialing application:
- Completed application with current date and signature
- Copy of applicable accreditation (JCAHO, URAC, ACR, AAACH, NACC, ACHC, American Lithotripsy Society, CHAP, CARF, AAASH, American Board of Orthotics & Prosthetics, ISO900, DialysisFacilities, AASM, ICAVL, Board for Orthotist/Prosthetist Certification – BOC, HQAA)
- Copy of state license
- Copy of Medicare certification
- Copy of Medicaid certification
- Copy of current liability insurance
- Copy of secondary or excess liability information