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Nevada

Nevada Behavioral Health Credentialing and Payer Enrollment

Nevada makes a carrier tell the Insurance Commissioner why it turned a provider down, and then publishes the totals. That makes this the one state where you can see the real reasons applications get denied instead of guessing. The answer is reassuring: in the last published year, most denials were about the network, not the applicant. Here’s what that report actually says, plus the state form CAQH doesn’t replace and the Medicaid map that changed on January 1, 2026.

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Nevada payers and timelines

Why Nevada is different

Four things you won’t find in generic credentialing advice.

Nevada changed under everybody’s feet in the last eighteen months. Three of these are new, and the first one has been true for years and almost nobody reads it.

Nevada publishes why applications get denied

NRS 679B.124, calendar year 2023 report
  • A carrier that denies a network application has to use the Commissioner’s prescribed form letter, state a reason, send the Commissioner a copy and report periodically
  • Nevada’s regulator found, for calendar year 2023: 25 companies, 148 submissions, 1,097 denials covering 744 unique providers across 91 specialties
  • Top reasons: business decision 24.21%, adequate network in the service area 21.53%, outside of service area 13.57%, does not meet criteria 9.99%, specialty not needed 7.39%
  • So close to 60% of those denials were a capacity or geography decision rather than a judgment about the applicant
  • Read it honestly: that’s Nevada data for one year, not a national number. Senate Bill 57 changed the reporting format afterwards, and we couldn’t locate later years

CAQH alone won’t get you in the door

NRS 629.095, NAC 679B.0405, Division of Insurance Bulletin 25-004
  • The Insurance Commissioner develops a single standardized credentialing form, and the rule names it as NDOI Form 901. The current practitioner version is NDOI-901 Rev. 02/2025
  • Bulletin 25-004, issued October 13, 2025, reminded every insurer, carrier, HMO and managed care organization to use it, and added the NDOI-901A addendum and the NDOI-901B facility application
  • NRS 695G.127 puts the same obligation on managed care organizations
  • Health Plan of Nevada goes further: it says Nevada applications may not be reachable through CAQH at all and should be uploaded directly
  • So a Nevada file is CAQH plus a state form. Keep both current

Medicaid went statewide on January 1, 2026

Three service areas, and the rural list is short
  • Roughly 75,000 rural Nevadans moved out of fee-for-service and into a plan on that date, so any guide calling rural Nevada fee-for-service is describing a world that’s gone
  • The three areas are Urban Clark, Urban Washoe and Rural, and Rural covers every other county plus the rural parts of Clark and Washoe
  • In Rural your entire managed care universe is CareSource and SilverSummit. Those two are the whole job
  • Health Plan of Nevada is Urban Clark only now. It used to serve Washoe and rural Clark and stopped. Older directories still show it as a northern option
  • The agency renamed too: the Nevada Health Authority launched July 1, 2025 and the old Division of Health Care Financing and Policy is gone, so dhcfp links redirect or break

Centralized credentialing cuts both ways

One shared file, one committee, one denial
  • Every Nevada Medicaid plan credentials you through one shared verification file rather than each running its own. That’s a genuine saving and it’s unusual
  • The other side: a denial isn’t a single-plan problem. SilverSummit’s 2026 provider manual states that a practitioner disapproved by the centralized committee cannot reapply for one year from the date of the denial
  • Centralized credentialing also doesn’t replace Medicaid enrollment screening. Both still have to happen
  • This is the state where a sloppy file costs the most. We’d rather take an extra week getting it clean

Where the delays actually happen

Getting on a panel isn’t the same as getting paid.

Prominence puts it plainly in its own materials: claims for a provider who isn’t both credentialed and contracted get denied or paid out of network. Most of the waiting happens in the gaps between these five steps, and we tell you which one you’re actually sitting in.

Credentialed›contracted›loaded›connected›payable

Two tracks

Medicaid and commercial work differently here.

Most Nevada practices want both. Which half matters more depends on whether you’re in Las Vegas, Reno or out past them.

Nevada Medicaid

Pick plans by service area, not by name.

Behavioral health rides inside the same plan that covers the member’s physical health, and members can self-refer to in-network behavioral health without a primary care referral. There’s no carve-out plan to chase. Nevada Check Up is the CHIP program for uninsured children, and a residual fee-for-service layer still exists for populations outside managed care, so confirm rather than assume a given member is with a plan.

How you enrollEverything starts at Provider Flex, built with fiscal agent Gainwell Technologies. It replaced the old Online Provider Enrollment tool on July 8, 2025, and applications sent through the legacy tool are rejected. You pick a provider type first, and that choice drives the document checklist Nevada wants from you.
The step nobody can do for youProvider Flex runs an identity check through DocuSign that asks for front and back images of your state-issued ID plus a short liveness video. We prepare everything around it and tell you exactly when it lands, but that one is yours. So is your signature and your CAQH attestation.
Provider Type 82 is being retiredBehavioral Health Rehabilitative Treatment began phasing out January 1, 2026, and as of July 1, 2026 it’s no longer available for enrollment. Claims are due by December 31, 2026, no dates of service on or after January 1, 2027 are accepted, and all PT 82 enrollments terminate June 30, 2027. Provider Type 14, Behavioral Health Outpatient Treatment, is the closest match and you keep your NPI. Nevada won’t backdate the move, so a slow transition is a real gap in billable coverage.
Forms you’ll actually see

Provider Flex application and electronic contractProvider Enrollment Checklist, by typeForm NMH-3827 advance directivesForm NMH-3828 civil rightsNDOI-901

Revalidation, and the trap inside itNevada emails and mails notices at 120, 90, 60 and 20 days out, and publishes a revalidation report with due dates. Two things catch people. The application has to be processed and approved before the due date, so a file started at day 20 is already late. And the notices go to the address on file. You can revalidate up to a year early, and we generally do.

Commercial

Two regional anchors, and a state form on top of CAQH.

Health Plan of Nevada and Sierra Health and Life carry southern Nevada. Hometown Health, owned by Renown Health, carries the north. After that it’s the national carriers plus Prominence and Ambetter. Which of those you need depends on which half of the state you’re in.

Your CAQH stays yours, and Nevada wants a form tooYou complete and attest your own profile. We’re added as an authorized practice manager, so we keep the practice data current and get each payer authorized. We never ask for your password. On top of that we prepare the NDOI-901 from your intake answers, with the 901A addendum or the 901B facility application where they apply. You review and sign it.
Behavioral health has its own doorHealth Plan of Nevada routes to Behavioral Healthcare Options. Anthem routes commercial and Medicare Advantage behavioral health to Carelon Behavioral Health. UnitedHealthcare routes to Optum through Provider Express. Cigna routes to Evernorth. Aetna keeps it in house but uses a separate request for participation. Hometown Health and Prominence handle it inside the plan. Applying through the medical door is the most expensive routine mistake in this state.
Nevada is a shortage state, and it’s worth sayingThe Nevada Health Workforce Research Center found that about 3.1 million Nevadans, 91.3% of the population, live in a federally designated mental health shortage area, and that 15 of 17 counties are single-county shortage areas. Every one of the state’s 302,794 rural and frontier residents is in one. That’s a fair thing to put in a network request.
Seeing patients in other statesOne Anthem Nevada contract reaches Blue members in other states through BlueCard. Aetna, Cigna and UnitedHealthcare are national. What you need is a licence where the patient is sitting, not another contract. Nevada Medicaid is the genuine exception, because that one is per state.

Nevada payers

Who you’ll apply to, and how long it usually takes.

These are typical ranges from a complete application. Nevada doesn’t put a general credentialing clock on carriers, so the dates belong to the payer. We track them rather than promise them.

Health Plan of Nevada and Sierra Health and Life

The largest commercial name in southern Nevada
  • Usually: no single published number. It describes six phases before you join the network and its credentialing committee meets at least ten times a year, so committee cadence is part of the calendar. Plan on 90 to 120 days from a genuinely complete file
  • Forms: the state application, NDOI-901 Rev. 02/2025, or NDOI-901B for a facility. A CAQH number helps but the plan says Nevada applications may not be reachable through CAQH and should be uploaded directly
  • Behavioral health: through Behavioral Healthcare Options. Behavioral health add requests go to its provider relations team, not the standard contracting inbox
  • Watch: don’t see members until the welcome letter confirms you’ve been credentialed and added to the contract. Sierra Health and Life acts as delegated credentialing agent across the related plans, so one file can serve more than one product line

Separate door: Behavioral Healthcare Options

Hometown Health

Northern Nevada, owned by Renown Health
  • Usually: it publishes real numbers, which is rare. Initial credentialing 90 to 120 days from a complete application with all required forms. A request to join gets a response in 45 to 60 business days. An incomplete application gives you 30 days to cure before it’s withdrawn, and status requests are accepted after 90 days
  • Behavioral health: handled inside the plan, no carve-out vendor
  • Useful: DEA and controlled substance registrations aren’t required for behavioral health providers other than psychiatry, so we won’t chase a document you don’t need
  • Requirements: CAQH re-attested every 120 days with a five-year work history matching your add form, and $1,000,000 per occurrence with $3,000,000 aggregate malpractice. Recredentialing every three years, initiated by Andros about 120 days ahead

Anthem Blue Cross and Blue Shield of Nevada

The Blue licensee, with the behavioral health door somewhere else
  • Usually: no Nevada-specific published number. Commonly 90 to 120 days from a complete application. Confirm current turnaround at submission
  • Behavioral health: commercial and Medicare Advantage behavioral health runs through Carelon Behavioral Health, including credentialing and recredentialing. Applying through the Anthem medical door is the mistake to avoid
  • CAQH detail: Carelon asks that your authorization be set to Global rather than a named list, so behavioral health can see your updates. Demographic changes go through the Carelon portal and CAQH together
  • Watch: the Medicaid line is a separate contract under the Healthcare Solutions name, and it isn’t available in the Rural service area

Separate door: Carelon Behavioral Health

UnitedHealthcare and Optum

The most encouraging published signal in the state
  • Usually: 60 to 120 days from a complete application. Behavioral health is a separate application from core UnitedHealthcare medical, started inside Provider Express
  • Why it’s near the front: Optum’s Nevada page lists the network as open and names what it’s after: telemental health, prescribers offering medication-assisted treatment, Express Access providers who can see someone within five business days, child and adolescent services, community mental health centers, case management and in-home services
  • Requirements: CAQH participation is required, levels of care need the matching state licensure or certification, and a current unexpired liability certificate has to be attached
  • Careful: that page also says Optum recognizes Nevada as an any-willing-provider state. Treat that as Optum’s own commitment, which is real and useful. See the note below on the legal half

Separate door: Optum Behavioral Health

Ambetter from SilverSummit Healthplan

One Nevada relationship reaching two populations
  • Usually: a Letter of Intent starts it, and SilverSummit says that if you aren’t contacted within 30 days you weren’t selected for the network. Once accepted, the file goes to the shared verification organization. Recredentialing at least every 36 months
  • The efficiency: SilverSummit states that a practitioner already participating in its Medicaid or Medicare product won’t be separately credentialed for Ambetter. Ambetter is offered statewide for 2026
  • Named types: psychiatrists, psychiatric nurse practitioners, clinical nurse specialists, psychologists and clinical social workers are explicitly on its must-be-credentialed list
  • Bring: the Nevada credentialing application with an attestation no more than 120 days old, licences in each practicing state, DEA and state controlled substance certificate where applicable, a malpractice face sheet and a five-year work history

Aetna

Behavioral health in house, separate form
  • Usually: a request for participation first, then a network-need answer on eligibility within 45 days, then credentialing pulled from CAQH, then contracting. Commonly 60 to 120 days end to end
  • Path: behavioral health goes through a separate behavioral health request for participation, including for clinicians joining a medical group. Starting on the medical form is the standard way to lose three weeks
  • Watch: Aetna countersigns the contract and issues your effective participation date. That date, not the credentialing approval, is when you can start seeing members and billing

Prominence Health Plan

Smaller, but it shows up in Reno and Las Vegas employer panels
  • Usually: Prominence states the credentialing process takes a minimum of 90 days. Confirm current turnaround at submission
  • Forms: the Nevada standardized credentialing application, posted on its own site. Adding a clinician to an existing group starts with a Provider Profile Sheet
  • Behavioral health: handled inside the plan
  • Worth quoting: its own materials warn that claims for a provider who isn’t both credentialed and contracted get denied or paid as out of network. That’s true of every Nevada payer

Cigna Healthcare and Evernorth

Paused right now, nationally
  • Right now: Evernorth paused new individual and clinic behavioral health applications on June 1, 2026 and has signalled reopening after September 1. Facilities are exempt and anything started before June 1 keeps processing
  • Usually: Evernorth says joining the behavioral network can take up to about 90 days once it’s open, or as otherwise required by law. Recredentialing generally every 36 months
  • What we do: we queue it and tell you the wait rather than putting a paused panel in your opening set

Separate door: Evernorth Behavioral Health

One thing to handle carefully. Optum’s Nevada page says it recognizes Nevada as an any-willing-provider state and accepts applications in compliance with that legislation. That’s a real, quotable payer commitment and we use it. But we could not verify a broad any-willing-provider statute in Nevada law: Nevada doesn’t appear on the any-willing-provider list circulated to its own regional behavioral health policy boards, and 2023 reporting described a broad bill being abandoned in favour of something much narrower. Treat Optum’s open posture as useful and don’t plan around the idea that Nevada law forces a carrier to take you. A typical opening set here splits by region. Southern Nevada: Health Plan of Nevada through Behavioral Healthcare Options, Anthem through Carelon, Aetna and Optum. Northern Nevada: Hometown Health, Anthem through Carelon, Optum and Prominence. Medicare and Nevada Medicaid with its managed care plans are scoped and priced separately from a commercial package.

Carry a plan we didn’t list? Add it.

Nevada has one pattern that’s bigger here than almost anywhere. Taft-Hartley union health and welfare trusts are a large share of the Las Vegas panel because of the hospitality workforce, and the culinary, hospitality and building trades funds behave differently from each other. Some are reached by joining a rented commercial network. Some of the larger ones run their own clinics and their own provider networks. You have to look, and we do. The Public Employees’ Benefits Program covers state employees, retirees and dependents, moved under the Nevada Health Authority in the July 2025 reorganization, and is self-funded, so the route is usually the administering network rather than the program itself. And a member card carrying a third-party administrator or an employer name you don’t recognise usually means a rented PPO underneath. That’s a research task, not a reason to bill out of network. You name the plan. We find the real route.

What we need from you

Send these once and we can start.

You give us this in one intake. Then we fill out the applications. No passwords, no patient information, and nothing gets submitted until you’ve read it and signed.

  • Your individual NPIPlus a Type 2 if you bill under a group. Nevada Medicaid group billing requires each clinician to enroll individually first and then link to the group, and membership changes have to be reported within five business days.
  • Active Nevada licence, plus DEA where it appliesNevada controlled substance registration too, where you prescribe. Hometown Health notes DEA and controlled substance registration aren’t required for behavioral health providers other than psychiatry, so we won’t chase a document you don’t need.
  • CAQH attested and authorizedYou attest it. We keep it current. Two Nevada specifics: Carelon asks behavioral health providers to set authorization to Global rather than a named list, and Hometown Health wants re-attestation every 120 days with a five-year work history that matches your add form exactly.
  • A clear description of the services you’ll billSo we pick the right Nevada Medicaid provider type the first time. This matters more here than in most states, because Provider Type 82 is retiring on a fixed schedule and the move to a new type can’t be backdated.
  • Twenty minutes for the identity checkProvider Flex runs a DocuSign identity check needing front and back images of your state-issued ID and a short liveness video. Only you can do this part. We prepare everything around it and tell you exactly when it lands so it doesn’t sit.
  • Provider Flex access, set up rightDelegated access so we can complete your enrollment and each plan application, with no password sharing. We also confirm the mailing address and email on file, because that’s where revalidation notices go at 120, 90, 60 and 20 days out.
  • Malpractice certificateCurrent, naming you, with amounts and expiration dates visible. Hometown Health states a $1,000,000 per occurrence and $3,000,000 aggregate minimum from a carrier authorized in Nevada or your practice state, and accepts Federal Tort Claims Act coverage with Nevada statutory caps.
  • Five years of work historyMonth and year, with any gap explained. Hometown Health requires it to match your add form and SilverSummit requires it on the application or a CV. Extended work gaps show up by name in Nevada’s own denial data, so this is the field to get right.
  • Entity name, EIN and W-9One per tax ID you bill under. Nevada Medicaid group enrollment also requires ownership, agent and managing employee disclosures, including anyone with a 5% or greater control interest.

Depending on what you plan to offer, Nevada may want the practice itself licensed as a health facility, separate from your own licence. The Bureau of Health Care Quality and Compliance licenses over 30 facility types under NRS chapter 449, and the behavioral health categories there are written around residential and around-the-clock settings: a facility for the treatment of abuse of alcohol or drugs is defined as residential, a psychiatric hospital and a community triage center are 24-hour facilities, and modified medical detoxification means 24-hour medical monitoring. The bureau separately certifies a short list of program types that don’t require a licence, including Certified Community Behavioral Health Clinics and Community Mental Health Centers. It starts to matter when you add residential or withdrawal management services, a crisis or triage setting, a partial hospitalization or intensive outpatient program, or a Medicaid provider type defined at the facility level. Note the bureau moved to the Nevada Health Authority on July 1, 2025, so older guides point at the wrong agency. We ask about your service mix, staffing and sites at intake and confirm where you land before it can hold up a payer contract. We don’t give legal advice and we don’t file it for you.

How it works

You answer once. We do the paperwork.

You can buy online without a meeting. Published price, published scope, no call needed unless you want one.

Buy the package

Published price and scope. No call needed.

One intake

Short and guided. It asks more only where your answers call for it.

We prepare everything

Provider Flex enrollment, the plan applications for your service area, and the NDOI-901 for every commercial file.

You review and sign

Read it, change anything, sign. Nothing goes out until you say so.

We submit and track

Every purchase includes Command Suite, so you can see where each payer application stands, what we’re working on, what’s waiting on a payer, and what we still need from you.

What we stand behind

Payer decisions, timing and rates are not ours to promise, and we don’t promise them. Our own work is a different matter. If something we delivered does not work the way we said it would, we fix it at no charge for 30 days after delivery, including one stabilization review. A new request, another payer or provider, a change of scope, or a new build is quoted separately. You won’t get an invoice for correcting our mistake.

Built to keep working after we’re done

Everything we set up is built for the practice you are growing into, not only the one you have today. Adding a provider or a second location should be a configuration change rather than a rebuild. When the engagement ends you own the accounts, the documentation and the systems, and they keep running without us. No lock-in.

Questions we get

Nevada credentialing questions

If a Nevada payer denies my application, does that mean something is wrong with my file?
Often it doesn’t, and Nevada is the rare state where you can check instead of guessing. Under NRS 679B.124 a carrier that denies a provider’s application to join its network has to file the reason with the Insurance Commissioner, who publishes an aggregate report. Nevada’s regulator found, in the calendar year 2023 report, 25 companies filing 148 submissions covering 1,097 denials across 744 unique providers and 91 specialties. The top reasons were business decision at 24.21%, adequate network in the service area at 21.53%, and outside of service area at 13.57%. So close to 60% of Nevada denials that year had nothing to do with the applicant. Read it for what it is: Nevada data for one year, not a national figure. Senate Bill 57 changed the reporting format afterwards.
Is a CAQH profile enough to get credentialed in Nevada?
No. Nevada prescribes the application. Under NRS 629.095 the Insurance Commissioner develops a single standardized credentialing form, NAC 679B.0405 names it as NDOI Form 901, and NRS 695G.127 puts the same obligation on managed care organizations. Division of Insurance Bulletin 25-004, issued October 13, 2025, reminded every carrier to use it and introduced the NDOI-901A addendum and the NDOI-901B facility application. The current practitioner version is NDOI-901 Rev. 02/2025. Health Plan of Nevada goes further and says Nevada applications may not be reachable through CAQH at all, so they should be uploaded directly. Keep CAQH current anyway, because several carriers still pull from it.
Which Nevada Medicaid plans can I actually contract with?
It depends entirely on where you practice, because Nevada runs three service areas. Urban Clark has five: Anthem, CareSource, Health Plan of Nevada, Molina and SilverSummit. Urban Washoe has four, and Health Plan of Nevada isn’t one of them anymore. The Rural service area, which covers every other county plus the rural parts of Clark and Washoe, has two: CareSource and SilverSummit. Managed care went statewide on January 1, 2026, moving roughly 75,000 rural Nevadans out of fee-for-service, so any guide describing rural Nevada as fee-for-service is out of date. CareSource is new to the state, which cuts both ways: less established, and actively building a network.
Is there any step in Nevada you cannot do for me?
Yes, and we’d rather say so up front than surprise you with it. Provider Flex runs an identity check through DocuSign that asks for front and back images of your state-issued ID plus a short liveness video. Nobody can perform that on your behalf and we wouldn’t want to. Your CAQH attestation and your signature on every application are the same kind of thing. We prepare everything around those steps and tell you exactly when each one lands, so it doesn’t sit in an inbox for three weeks while a file waits.
What happens if the centralized credentialing committee turns me down?
It’s a bigger problem here than in most states, and it’s worth knowing before you file. Nevada Medicaid plans credential through one shared verification file rather than each running its own, which saves real time. The other side of that reach is that a denial isn’t a single-plan problem. SilverSummit’s 2026 provider manual states that a practitioner disapproved by the centralized committee cannot reapply for one year from the date of the denial. One committee, every plan, twelve months. That’s the argument for a complete, clean, first-time-right file rather than a fast one, and it’s why we’d rather take an extra week at the front.
I am enrolled as Provider Type 82. What do I need to do?
Move, and move before anything else on your list. Provider Type 82, Behavioral Health Rehabilitative Treatment, began phasing out January 1, 2026. As of July 1, 2026 it’s no longer available for enrollment in Provider Flex, and existing requests and revalidations get rejected. All PT 82 claims have to be in by December 31, 2026, no dates of service on or after January 1, 2027 will be accepted, and all PT 82 enrollments terminate June 30, 2027. Nevada Medicaid points providers at Provider Type 14, Behavioral Health Outpatient Treatment, as the closest service match, and you keep your existing NPI. The trap is that Nevada won’t backdate the new provider type, so a slow move turns into a gap in billable coverage that nobody can fix afterwards.
Is Nevada an any-willing-provider state?
Be careful with this one. Optum’s own Nevada page states that it recognizes Nevada as an any-willing-provider state and accepts applications in compliance with that legislation, and that’s a genuine payer commitment worth quoting back to Optum. We could not verify a broad any-willing-provider statute in Nevada law. Nevada doesn’t appear on the any-willing-provider list circulated to its own regional behavioral health policy boards, and 2023 reporting described a broad bill being abandoned in favour of something much narrower. So treat Optum’s open posture as real and useful, and don’t plan around the idea that Nevada law forces a carrier to take you.
Do you need my CAQH password?
No, and we won’t ask. We’re added as an authorized practice manager, which lets us keep your practice data current and authorize payers. You complete and attest your own profile, and you sign anything that needs your signature. Anyone asking a provider for their CAQH password is doing it wrong. Two Nevada details worth knowing: Carelon asks behavioral health providers to set CAQH authorization to Global rather than a named list so it can see your updates, and Hometown Health requires re-attestation every 120 days with a five-year work history that matches your add form exactly.

Keep reading

Related

Nevada PMHNP scope of practiceWhat Nevada allows you to do, separate from who pays you.
California credentialingSpecialty mental health is carved out to your patient’s county plan, so you need two relationships.
Arizona credentialingAHCCCS plans share one application, and a 2026 statute pays you back to the completeness date.
Utah credentialingBehavioral health is carved out to county Prepaid Mental Health Plans.
Opening your own practiceEntity, identifiers, payers, EHR and billing setup.
Adding a provider to your clinicFirst-time credentialing into contracts you already hold.
Changing your entity or tax IDMoving panels without breaking the money.

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Where this comes from

  • Nevada Medicaid (Nevada Health Authority), Provider Flex enrollment, the DocuSign identity check and per-provider-type checklists verified July 26, 2026
  • Nevada Medicaid, Web Announcement 3763 of November 10, 2025, the Provider Type 82 sunset schedule and Provider Type 14 as the closest match verified July 26, 2026
  • Nevada Medicaid (Nevada Health Authority), statewide managed care program effective January 1, 2026 and the three service areas verified July 26, 2026
  • Nevada Legislature, NRS 629.095, NAC 679B.0405 and NRS 695G.127, the standardized credentialing form and the obligation on managed care organizations verified July 26, 2026
  • Nevada Division of Insurance, Bulletin 25-004 of October 13, 2025, introducing the NDOI-901A addendum and the NDOI-901B facility application verified July 26, 2026
  • Nevada Division of Insurance, report to the Governor and Legislative Counsel Bureau under NRS 679B.124, calendar year 2023 aggregated provider denial report verified July 26, 2026
  • SilverSummit Healthplan, 2026 provider manual: centralized credentialing, the one-year bar on reapplying after a committee denial, and the behavioral health practitioner list verified July 26, 2026
  • Health Plan of Nevada, credentialing: the NDOI-901 requirement, committee cadence and Behavioral Healthcare Options routing verified July 26, 2026
  • Hometown Health, provider credentialing: published turnaround, CAQH re-attestation and malpractice minimums verified July 26, 2026

Written by Ryan Berg, founder of AdvanceAPractice. 16 years in healthcare revenue cycle and credentialing.

Facts on this page were verified July 26, 2026 and are next due for review October 19, 2026.

Payer programs, plans and timelines change. Everything here carries a verification date and gets re-checked on a review cycle; this record is next due for review on October 19, 2026. Approval and effective dates are controlled by each payer and by the state, and nothing here promises an approval, a timeline or a rate. This page covers payer operations. It isn’t legal, tax or scope of practice advice.