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Credentialing & Participation Guidelines

Documents can be ordered by Name (Alpha Ascending or Descending), Date Added or Number of Hits that the document has received to make it easier to find the document you want to download. Simply click on "Order By" Name, Date or Hits and "Ascendant" or "Descendent" and they will automatically repopulate accordingly.

Standards of Practice & Guidelines

The guidelines below are updated every two years or with changes and mailed to providers. Please call 1.800.624.6961, ext. 7659 or 740.695.7659 if you require another set of guidelines and we will mail them out to you. If you have additional questions about the Disease Management Guidelines, you can call 740.699.6110.

  • Guidelines for Preventive Health
  • Management of COPD
  • Management of Diabetes Mellitus
  • Management of Chronic Heart Failure (CHF)
  • Substance Abuse
  • Management of Depression
  • Standards for Patient Records
  • Standards for Access to Care and Services 

Order by : Name | Date | Hits [ Ascendant ]

State of West Virginia Credentialing Form State of West Virginia Credentialing Form

Date added: 12/07/2011
Filesize: 200.53 kB
Downloads: 1452

State of Ohio Credentialing Form State of Ohio Credentialing Form

Date added: 04/19/2010
Filesize: 580.94 kB
Downloads: 2060

Standards for Participation Standards for Participation

Date added: 09/19/2009
Filesize: 19.15 kB
Downloads: 1408

Listing of credentials required to become a Health Plan Provider.

Users with Adobe Acrobat or Adobe Reader 7.0 or greater will be able to fill out the following form below ONLINE by clicking on the fields or "tabbing" through the fields. Once the information is properly filled out, users then will click "Submit by Email". (Please note: if a field is required, the form will ask you to fill in the required pieces before sending or it will not go through).

If users do not or cannot have the the lastest Adobe Acrobat or Adobe Reader, they can scroll to the bottom of the forms and click on "Print Form". The form will be printed for the user to then manually fill out and return to Health Plan Provider Relations either by mail or fax.

Practitioner's Rights Practitioner's Rights

Date added: 09/19/2009
Filesize: 37.63 kB
Downloads: 1499

Information pertaining to Credentialing/Recredentialing, Standards for Participation and Practitioner's Rights.

Ohio Valley/Mountaineer Region
TF: 1.800.624.6961
Email: hpecs@healthplan.org
Hours: Mon- Fri., 8:30 am to 5:00 pm

HomeTown Region
TF: 1.800.426.9013
Email: hpecs@healthplan.org
Hours: Mon- Fri., 8:00 am to 5:00 pm