Administrative requirements and technical guidance to assist insurers, hospitals and providers regarding Vermont’s uniform provider credentialing requirements.
Act 191 of 2006 directs the Vermont Department of Banking, Insurance, Securities and Health Care Administration to “prescribe the credentialing application form used by the Council for Affordable Quality Healthcare (CAQH), or a similar, nationally recognized form prescribed by the Commissioner.” The law further directs that “Health insurers and hospitals shall use the CAQH credentialing application form for the initial application, and for applications for re-credentialing which are filed in due course as required by the re-credentialing process of the health insurer or hospital after January 1, 2007.”
The CAQH credentialing application form may be used in either an electronic or paper format, as determined by the health insurer or hospital.
Providers may submit the CAQH application form in a paper format or electronically. The application form can be downloaded using the link below. A paper form may also be requested by mail by calling the CAQH Help Desk at 1-888-599-1771.