Nebraska: Centralized credentialing available soon

Starting Jan. 1, 2025, UnitedHealthcare Community Plan of Nebraska will begin using a new, centralized credentialing process for care providers. We’ll begin working with the centralized verification organization (CVO) Verisys. Verisys will conduct 1 streamlined verification process for the following Nebraska managed care organizations (MCO), including our plan:

UnitedHealthcare Community Plan of Nebraska
Nebraska Total Care
Molina Healthcare

Why centralized credentialing

The new system eliminates the need to conduct individual credentialing processes with each MCO. All will be completed at once.

Who’s required to participate

The types of care providers required to participate include:

Medical
Behavioral health
Dental

Who’s excluded

The following MCO delegates are excluded:

March Vision care providers
Optum RX care providers
Non-emergency medical transportation (NEMT) care providers
Other entities, including Independent Physician Practice Associations (IPA)
Physician hospital organizations (PHO) who hold delegated credentialing agreements

When to begin the recredentialing process

Recredentialing begins mid-2025. You’ll receive a letter in the mail from Verisys 6 months prior to your recredentialing due date. The CVO will perform recredentialing every 3 years.

Note: Centralized recredentialing does not replace the Medicaid provider enrollment screening process. All Medicaid care providers must enroll with the program through Maximus. More information on how to enroll in the Nebraska Medicaid Program is available on the Nebraska Department of Health & Human Services website.