Credentialing

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The Alliance® credentialing process verifies training, experience, licensure and competence of an individual to determine if they are qualified to render acceptable quality of care to members of The Alliance. 

The below information is relevant to participating providers of The Alliance with the exception of chiropractors, who should contact Magellan for credentialing information.

The Alliance partners with WPS to assist in carrying out the credentialing process. Credentialing application materials are sent to participating providers for completion as applicable. 

We require credentialing for the following practitioner types: 

  • Physician and Ph.D. level (for example MD, DO, DPM, OD, Ph.D., PsyD, AuD); DDS/DMD (if providing care that falls under medical benefits) 
  • MS level (for example LCSW. CSAC, LMFT, LPC, SAC, BA) 
  • Nurse Clinician and Physician Assistant level (for example APNP, CNM, NP, LPN, PA) 

*Please note, there are exceptions to this list and several specialties for which we do not require credentialing, including but not limited to: facility-based Radiology, Anesthesiology, Pathology, Hospitalists, and Emergency providers. The Alliance references the guidance of our credentialing partners’ policies and procedures as they pertain to the credentialing of individual practitioners and providers. 

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