Thank you for your interest in becoming a network provider for Health Plan of Nevada, Inc. / Sierra Health & Life Insurance Company, Inc.
Credentialing is the process of assessing and validating the qualifications of a licensed independent practitioner to provide services for our members.
The credentialing process complies with the National Committee for Quality Assurance (NCQA) credentialing standards, the credentialing requirement of the Centers for Medicare & Medicaid Services (CMS, formerly known as HCFA), and the State of Nevada Medicaid Contract.
Sierra Health and Life is the delegated credentialing agent for the following:
- Health Plan of Nevada, Inc.
- Health Plan of Nevada – Medicaid
- Sierra Health and Life Insurance Company, Inc.
- Sierra Healthcare Options, Inc.
- Behavioral Healthcare Options, Inc.
- Northern Nevada Health Network
- UnitedHealthcare – Nevada Market
Please note: Credentialing submission and approval does not guarantee participation with the health plan. Approved and signed physician contracts are required for participation.
Credentialing Quick Facts
- Not all providers require credentialing. Do you require credentialing?
- Providers that require credentialing must go through six (6) Primary Phases before they can join the network.
- If the provider has an active/up to date CAQH account, please submit this account number and ensure the applicable documents are uploaded.
- Nevada Applications (required) may not be available through CAQH but can be uploaded into your account
- What’s required for credentialing?
- Credentialing applications are reviewed but the Credentialing Committee which is a peer review body that includes representation by providers practicing in HPN’s network. The committee is also a multi-disciplinary committee with representation from various types of practitioners. They meet a minimum of ten (10) times per year.
- Practitioners are required to notify HPN within 15 days of any loss of licensure, loss of privileges or Medicare/Medicaid sanctions and exclusions.
- Provider Summary Guide: Credentialing (PDF)
Contact information
E-mail: NVSierraCred@uhc.com
Phone: 702-242-7758
Fax: 702-242-7853