Contracting & Credentialing

The purpose of the credentialing and re-credentialing process is to help make certain that Iowa Total Care maintains a high quality healthcare delivery system. The credentialing and re-credentialing process helps achieve this aim by validating the professional competency and conduct of our providers. This includes verifying licensure, board certification, and education, and identification of adverse actions, including malpractice or negligence claims, through the applicable state and federal agencies and the National Practitioner Data Base. Participating providers must meet the criteria established by Iowa Total Care, as well as government regulations and standards of accrediting bodies, and must be enrolled with Iowa Medicaid Enterprise.

Iowa Total Care requires re-credentialing at a minimum of every 3 years because it is essential that we maintain current provider professional information. This information is also critical for Iowa Total Care members, who depend on the accuracy of the information in its provider directory.

Note: In order to maintain a current provider profile, providers are required to notify Iowa Total Care of any relevant changes to their credentialing information in a timely manner.

Provider Relations Specialists are available to help address any questions related to the terms of your provider agreement or credentialing requests. Please contact your Provider Relations Specialists. To locate your Provider Relations Specialists, see the Provider Relations Specialists Territory Map.