Payer Alignment & Credentialing

Payer Alignment & Credentialing

An Affinia Health Network (AHN) benefit is insurance payer alignment. Below you will find AHN payer resources broken out to guide you in credentialing. 

AHN submits payer rosters by the 20th of each month for the following:

  • AHN submits updated payer rosters to start the credentialing process for HAP, Molina, and Oscar.
  • AHN submits updated payer rosters for alignment for Access Health, ASR, ASR DTE, Aetna, Blue Cross Complete, Humana, and Meridian.
  • AHN does not submit rosters for BCN, BCBSM, Priority Health/Cigna, and United Health Care. This is done at the office level. AHN will assist with changes and/or terms for Priority Health/Cigna. 

*Please make sure the provider’s CAQH profile is up-to-date and payers have been given access. 

*Please make sure providers are enrolled in CHAMPS.

*The credentialing and alignment process takes anywhere from 45-90 days after submission to the payers. AHN will begin to assist in alignment status questions or concerns after the 90th day.   

If you have any questions please reach out to AHN Network Relations at affinianetworkrelations@mercyhealth.com.

 

Alignment & Credentialing Requirements By Payer

Access Health

  • Office starts credentialing process with Payer 
  • Affinia Health submits a monthly roster for alignment to our organization
  • Affinia Health will submit changes and terms on behalf of the office
  • No forms to be completed

Aetna

  • Office Starts credentialing process with the Payer 
  • Affinia Health submits a monthly roster for alignment to our organization
  • Affinia Health will submit changes and terms on behalf of the office 
  • No forms to be completed

ASR / ASR DTE

  • Office starts credentialing process with Payer 
  • Affinia Health submits a monthly roster for alignment to our organization
  • Affinia Health submits changes and terms on behalf of the office 
  • No forms to be completed

BCBSM / BCN

  • Office starts credentialing process with Payer 
  • Office submits changes and terms 
  • The MCG form needs to be completed, signed by AHN, and faxed by the office to BCN

Blue Cross Complete (BCC)

  • Office starts credentialing process with Payer 
  • Affinia Health submits a monthly roster for alignment to our organization
  • Affinia Health submits changes and terms on behalf of the office 

Health Alliance Plan (HAP)

  • Affinia Health submits a monthly roster that begins the credentialing process with Payer 
  • Affinia Health submits a monthly roster for alignment to our organization
  • Affinia Health submits changes and terms on behalf of the office 

Humana

  • Office starts credentialing process with Payer 
  • Affinia Health submits a monthly roster for alignment to our organization
  • Affinia Health submits changes and terms on behalf of the office 

Meridian / Wellcare

  • Office starts credentialing process with Payer 
  • Affinia Health submits a monthly roster for alignment to our organization
  • Affinia Health submits changes and terms on behalf of the office 

Molina

EFFECTIVE January 1, 2021 

  • Office starts credentialing process with Payer via the Molina Provider Roster
  • Office submits changes and terms via the Molina Provider Roster
  • The Molina Provider Roster must be completed and emailed to Molina and Affinia.

Oscar

  • Affinia Health submits a monthly roster that begins the credentialing process with Payer 
  • Affinia Health submits a monthly roster for alignment to our organization
  • Affinia Health submits changes and terms on behalf of the office 

Priority Health / Cigna

  • Office starts credentialing process with Payer 
  • Office submits changes and terms

United Health Care (UHC)

  • Office starts credentialing process with Payer 
  • Office submits changes and terms
  • **AHN only carries the UHC Community Plan contract

Have your providers changed?

To ensure AHN has the correct providers aligned to your location complete the correct form on our forms page

Need More Information?

Please contact your Network Relations Specialist.

Interested in Joining Affinia?

Fill out the online form and apply today!

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