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Medical credentialing and contracting


Become a participating provider

If your medical practice is located in Hays, Travis, or Williamson counties and you are interested in working with us, please follow the instructions below.


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Medical contracting

To start the medical contracting process, request medical network participation below.



Request medical network participation

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Medical credentialing

If the panel is open in your area and you have been approved to contract, we will have you complete a credentialing application and submit it to us by email, fax or regular mail.

credentialing@modahealth.com
Fax: 503-265-5707

Mailing address:
Moda Health
Attn: Credentialing Dept.
601 SW 2nd Ave. #900
Portland, OR 97204

Practitioner Rights

Practitioners have rights during the credentialing and recredentialing process and are notified of these rights through various means.

Practitioners have the right to:

  • Credentialing and recredentialing decisions that are not based on the practitioner's race, ethnic/national identity, gender, age, sexual orientation or the types of procedures performed (provided such procedures are legal under US law) or patients in which the practitioner specializes. This includes information obtained from outside sources except for reports from the National Practitioner Databank. 
  • Review information the practitioner submitted to Moda Health to support their credentialing application. 
  • Correct erroneous information discovered during the verification process. The credentialing specialist will send three written requests with a 7-day deadline to allow the provider to clarify any discrepancy found. Contact information for the credentialing specialist will be provided at the time of the request.  
  • Request and be informed of the credentialing application status. The credentialing staff will respond to status requests within 2 weeks of receipt.  
  • Withdraw, in writing, the application at any time.
  • Have the confidentiality of the application and all supporting documents protected and the information used for the sole purpose of application verification, peer review and panel participation decisions, subject to any disclosures required under state or federal law.
  • Be notified of these rights.
  • Participating providers have the right to appeal application denials and adverse action taken by Moda Health as outlined in the Appeal of Moda Health Adverse Action.

 

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