Know before you start
- Before you can request a contract, you need to be credentialed. To find out, look up your profile in our provider directory or email us for status. Due to a January 2025 surge in credentialing applications, processing time is currently at 45 to 60 days until further notice. For faster processing, be sure that your CAQH data is up to date.
- You can request an individual contract or join one of our contracted independent practice associations or medical groups. To establish a contract in Washington, you must provide care primarily in Washington state. You may be eligible if practicing in an adjacent county bordering Washington state. Questions? Email us.
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
- Hospital admission/inpatient coverage plan
Submit your application using our hard-copy credentialing application until we transition
to the new vendor, CAQH. Find out more about the CAQH transition.
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
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
What happens next
After you submit your application, you’ll receive an email from our contracting department within 45 to 60 business days to review, sign, and return all documents through DocuSign. If we don’t receive the signed documents within 30 days from the date the contract is emailed to you, your request will be closed. Later you’ll receive a counter-signed copy with your contract effective date for your records. The contract won’t be effective until its counter-signed by LifeWise.
For more information
For more information about our selection criteria and credentialing standards,
contact Physician and Provider Relations.