Credentialing is the process of obtaining and reviewing documentation to determine participation status in a health plan. The documentation may include, but is not limited to, the applicant’s education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Generally, the terms credentialing and recredentialing include the review of the information and documentation collected, as well as verification the information is accurate and complete.
Please note:
- Facilities and organizational providers that are already contracted with Humana but need to be credentialed should download our
organizational provider credentialing, PDF , application and fax it to 1-502-508-0521 or email it to credentialinginquiries@humana.com. - Puerto Rico healthcare professionals interested in credentialing should send an email to PRCredentials@humana.com or call 1-877-384-5037. The information below does not apply to Puerto Rico.
View the credentialing and recredentialing policies here, PDF .- For answers to questions about credentialing status or the process described below, please call 1-800-626-2741 and choose the option that says, “Have a question about a contract?” You also can send an email to:
Credentialing status email addresses by region
AK: pacificnorthwest@humana.com
HI: Hawaii_Contracting@humana.com
KS & MO: ksmonm@humana.com
ND: NCRNetworkOps@humana.com
SD: NCRNetworkOps@humana.com
NE: NCRNetworkOps@humana.com
IA: NCRNetworkOps@humana.com
MT: NCRNetworkOps@humana.com
WY: NCRNetworkOps@humana.com
NM: CONMProviderServices@humana.com
NV: Nevadamarketupdates@humana.com
OH: ohionetworkspecialist@humana.com
WI: WIMBOX@humana.com
IL: IllinoisProviderUpdate@humana.com
MS: LAMSPROVIDERINTAKE@humana.com
OR: pacificnorthwest@humana.com
ID: mountaindivision@humana.com
UT: mountaindivision@humana.com
MD & DC: DCMarylandProviderUpdates@humana.com
VA: VirginiaProviderUpdates@humana.com
TN: HumanaALTNproviderupdates@humana.com
NC: ncproviderupdates@humana.com
SC: scproviderupdates@humana.com
Austin & Corpus Christi: networkrelationsaustintx@humana.com
Houston (including TIN changes & demographic updates): HumanaHoustonPD@humana.com
Albany, Allegany, Broome, Cattaraugus, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Cortland, Delaware, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Hamilton, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Montgomery, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Otsego, Putnam, Rensselaer, Rockland, Saratoga, Schenectady, Schoharie, Schuyler, Seneca, Steuben, St. Lawrence, Sullivan, Tioga, Tompkins, Ulster, Warren, Washington, Wayne, Wyoming and Yates.
UpstateNYproviderupdates@humana.com
Bronx, Kings, Nassau, New York, Queens, Richmond, Suffolk and Westchester
DownstateNYNJproviderupdates@humana.com
WV: ProviderDevelopmentKYWV@humana.com
PA: PennsylvaniaProviderUpdates@humana.com