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Credentialing

The Foundation for Health Care Quality is the state’s Lead Organization for Administrative Simplification and is responsible for credentialing activities required by RCW 48.43.750(1)(a). OneHealthPort was the Lead Organization prior to 2025. In November 2023 a working group, facilitated by OneHealthPort and represented by health plans, providers, and Associations, recommended CAQH as the new credentialing vendor for WA State starting in 2024. Medversant was the prior vendor for the State.

See how health plans are accepting credentialing applications

(Updated January 6, 2025)

Why was the Credentialing Program Enacted?

State Senate Bill 5346, ratified in April 2009, aimed to reduce the administrative burden on providers and improve the quality and timeliness of information for hospitals and payors by legislating the development of a uniform electronic process for collecting and transmitting the necessary provider-supplied data to support credentialing, admitting privileges, and other related processes that served as the sole source of credentialing information required by hospitals and payors.
See Frequently asked Questions here.

Who are the Players?

  • The Foundation for Health Care Quality was designated the Lead Organization in State Senate Bill 5346 (ESSB 5346), which requires a statewide data collection process for all credentialing and privileging data. OneHealthPort engages with the community to monitor the program and coordinate feedback with the vendor.
  • Office of the Insurance Commissioner (OIC) is designated in ESSB 5346 with the role of regulatory oversight. That includes oversight of  the Lead Organization for Administrative Simplification, including the statewide credentialing program.
  • CAQH is the chosen vendor for WA state providers and health plans to submit and retrieve credentialing applications as of January 1, 2024.

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