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Qualified Vendor Credentialing

Man stamping approval on documents.

Credentialing ensures patient safety by maintaining a high standard of quality care provided by qualified and competent vendors that provide services. Contracted providers must meet required qualifications and standards to provide services to DDD members. These requirements are explained in:

Credentialing is the process of checking a healthcare vendor’s qualifications. This process ensures the necessary requirements are met.

It includes verifying general and professional:

  • Licenses
  • Insurance
  • Other required credentials

Credentialing helps ensure patient safety. This process maintains a high standard of quality care provided by qualified and competent vendors.

Credentialing is part of the process to become an authorized Qualified Vendor, which begins after the DDD Contracts Unit approves the applicant's Request for Qualified Vendor Agreement (RFQVA). New applicants are not authorized to provide services to members until they have completed the credentialing process.

New Applicant Credentialing

Applicants who want to become Qualified Vendors must complete initial credentialing.

During this process, the Credentialing Unit checks:

  • Qualifications
  • Licenses
  • Background history

The ensures applicants meet:

  • Arizona state requirements, and
  • Centers for Medicare and Medicaid Services (CMS) standards

The Initial Credentialing Checklist guides potential Qualified Vendors through everything they need to submit to start the process.

To avoid delays:

  • Make sure all documents are complete
  • Make sure all information is accurate

Once the Division receives a complete credentialing application, the process may take up to 60 days.

Current Qualified Vendor Recredentialing

All Qualified Vendors with an active Qualified Vendor Agreement must complete recredentialing at least every three years. Recredentialing makes sure vendor information is current and valid.

The Recredentialing Checklist shows what current Qualified Vendors must submit to be recredentialed.

Incomplete or incorrect submissions may:

  • Delay the recredentialing process
  • Delay updates to the Qualified Vendor's contract

Resources

Credentialing and Recredentialing is required for all Qualified Vendors no matter what service or services they provide. Each service type may have additional credentialing or licensing requirements. Applicants and current Qualified Vendors should review the specific checklist for full details.

The credentialing process involves a variety of terms and acronyms. The DDD Acronyms and Services Glossary is designed to help navigate and understand the terms used in the credentialing process.

Applicants or current Qualified Vendors with questions about the credentialing process may contact the Credentialing Unit Monday through Friday, 8:00 a.m. to 5:00 p.m. (AZ/MST).

Credentialing Corner

Important Credentialing information can be found in the monthly Quality Management Bulletin.

Supporting Forms and Documents

Frequently Asked Questions

  1. Is the credentialing process the same as acquiring a DDD Qualified Vendor Contract?
    No. Credentialing for Qualified Vendors is solely executed by DDD's Credentialing Unit. The unit is separate from the Contracts Units and does not have access to the same systems or documents used by other departments. Required documents must be sent directly from the applicant or Qualified Vendor to the DDD Credentialing Unit.
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