Initial Credentialing and Applying to Join the Network

All providers are required to submit a completed and signed Participating Provider Agreement and Provider Application, along with copies of the requested supporting documentation, for a provider’s application’s status to be considered as “received” by the network. To request a packet of information be mailed to you, click here and complete the form.

If you have already obtained and completed a Participating Provider Agreement and only need a copy of the Provider Application, click here. Print the Provider Application, complete it and make sure to attach copies of the requested documents. Fax all documents to (816) 257-4437, or mail them to:

GEHA/PPO USA Network
310 NE Mulberry St.
Lee’s Summit, MO 64086

Prospective PPO USA Network provider applications are reviewed and verified by our Credentialing Department. Copies of the following documents are required to be submitted to the network as part of the initial credentialing process:

  • State License
  • Federal or State DEA Certificate
  • Specialty Board Certificate
  • Highest education achieved unless State Board Certified
  • Certificate of Malpractice Insurance or policy face sheet that includes the expiration date, insured’s name and insurance limits

We understand how busy our Participating Providers’ offices can be. Therefore, we have made the re-credentialing process as quick and easy as possible. When the time comes for a Participating Provider to be re-credentialed, our Credentialing Department will send the provider a re-credentialing packet consisting of a letter and provider profile. Copies of the following information are required for us to complete the re-credentialing process:

  • Current State License
  • Current Federal and State DEA Certificate
  • Specialty Board Certificate if previous certificate has expired or the provider has become Board Certified since the last credentialing instance
  • Current Certificate of Malpractice Insurance or policy face sheet that includes the expiration date, insured’s name and insurance limits

Providers are initially reviewed and then re-reviewed every three years, unless more frequent monitoring is required by state law or regulation. On a monthly basis, our Peer Review Committee reviews and approves new providers and the ongoing participation of current Participating Providers.

Our Credentialing Specialists are available to answer questions or provide assistance with our credentialing process. If you have any questions, please do not hesitate to call our Credentialing Department at (800) 821-4991, Option 3.