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Application required information
In accordance with our Initial Credentialing Policy and Procedure, a completed application for credentialing and recredentialing purposes includes: a complete and accurate CAQH application, re-attested within the last 90 days, including all supporting documentation including, but not limited to explanation of any affirmative responses including malpractice suits, an explanation of any work history gaps over 6 months. The clinician is obliged to provide Foresight with information sufficiently detailed to render an opinion regarding any affirmative response (CR-01 and CR-01A).
Checklist of items needed for the credentialing process
Copy of CV
Needs to be current
In mm/yyyy formatting
Any gaps for six months or longer needs to have an attached written explanation
CAQH Profile, completed and attested
Additional documents may be requested as required by each state’s regulations and laws
More information about the credentialing process and frequently asked questions can be found in our FAQ document.
Minimum qualification standards
A completed application
License to practice in applicable state
Valid DEA, as applicable
Applicable education and training
Board certification as applicable
Foresight is prohibited from including in its network any applicant who:
Is currently sanctioned or prohibited from participation in federal health care programs under either Section 1128 or Section 1128A of the Social Security Act; or
Has a current licensure suspension by any state licensing board; or
Is included on any of OFAC’s sanction lists.