

We are now processing credentialing applications submitted on or before January 21, 2025. Completion of the credentialing process takes 30-60 days. We will notify you once your application has been approved or if additional information is needed. View your credentialing status in Payer Spaces on Availity Essentials.
Type of service | In person | In person | Virtual/telehealth | Virtual/telehealth | Virtual/telehealth |
---|---|---|---|---|---|
Place of service | Services are delivered inside our service area (clinic) | Services are delivered inside our service area (clinic) | Services are delivered inside our service area (home or clinic) | Services are delivered inside our service area (clinic) | Services are delivered outside our service area (home or clinic) |
State licensure | Inside our service area | Inside our service area | Inside our service area and within the state telehealth services are provided in | Inside our service area and within the state telehealth services are provided in | Inside our service area and within the state telehealth services are provided in |
Member location | Inside our service area | Inside our service area | Inside our service area | Inside our service area | Inside our service area |
Credentialing and contracting eligibility | Eligible | Eligible | Eligible | Eligible | Not eligible |