Before applying, be sure to check the Washington Network Closure
Matrix. If you're already contracted with a LifeWise affiliate plan, you don’t need to sign a separate agreement or submit another credentialing application.
How to apply
You can request an individual contract or join one of our contracted independent practice associations or medical groups. In either case, you must also meet our credentialing criteria:
- Complete the hard-copy credentialing application, attestation, and release forms
- Send your completed application with copies of the following documents:
- Current DEA certificate or coverage plan for the state in which you’re practicing
- All current state licenses
- Current professional liability insurance certificate
- Completed W-9
- Any explanations to “Yes” answers on your credentialing application
Submit your credentialing application using Medversant's ProviderSource. You'll need your OneHealthPort subscriber ID and password. Access to ProviderSource ends on December 31, 2023. Starting January 1, 2024, you can submit your application using our hard-copy credentialing application while we transition to a new vendor. Find out more about the new credentialing vendor.
How to avoid delays
The top reasons for incomplete applications include:
- Incomplete address, suite number, or phone number
- Missing tax ID number
- New contracts are frequently missing the W-9
- Expired malpractice insurance
- Incomplete or missing work history or education information
- Hospital privileges, if applicable
Submit by mail, fax, or email
Mail:
PO Box 327 - MS 263
Seattle, WA 98111-0327
Fax: 425-918-4766
Email:
Credentialing.Updates@LifeWiseHealth.com
What happens next
Your acceptance is based on application information and network requirements. Please be aware that the credentialing process typically takes 60 to 90 days.
If your submitted application is complete and you’re accepted, you’ll receive a counter-signed contract and start date. For all LifeWise plans, you can’t see members under the contract until you’re officially credentialed. Also, your malpractice insurance must start before credentialing is complete.
For more information
For more information about our selection criteria and credentialing standards,
contact Physician and Provider Relations.