Credentialing Criteria

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Coventry Health Care’s network includes many distinguished hospitals, physicians, surgery centers, ancillary providers, and centers of excellence throughout the United States.

Coventry physicians have qualifications that must be met for participation such as:

  • 24 hour/day, 7 day-a-week coverage
  • A current, valid license to practice medicine
  • Staff privileges at a participating hospital
  • An active DEA certificate (if applicable)
  • Verification of medical school completion, residency training and fellowship
  • Verification of board certification (in specialty being practiced)
  • Current professional liability insurance that meets state minimum requirements
  • Acceptable professional claims liability history, including the National Practitioners Data Bank (NPDB)

The Health Care Credentials and Data Collection Act requires uniform forms to be utilized in order to collect the credentials data commonly requested by health care entities and health care plans for purposes of credentialing and re-credentialing.

For more information about joining our network of providers, including requirements and credentialing, please contact us.

 

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