What is the Windsor Credentialing Policy?
Windsor Health Plan, Inc. uses a credentialing process to provide members with a selection of physicians and other healthcare professionals who have demonstrated backgrounds consistent with the delivery of high quality, cost-effective health care. We have established credentialing criteria using guidance from the National Committee for Quality Assurance (NCQA) and the Centers for Medicare and Medicaid (CMS) for network participation that is used to evaluate a provider’s credentials. The credentialing criteria serves as the foundation for determining a provider’s eligibility and continued eligibility in all Windsor Health Plan, Inc. networks. Providers are expected to remain in compliance with credentialing criteria at all times.
