Click appropriate button to access the Credentialing Application

The above button links to a printable version (.pdf) of the District of Columbia’s credentialing application that you can complete by hand and mail to health plans. The downloadable file contains the 18-page application and supplemental forms and reference codes. The supplemental forms allow you to provide additional information where appropriate. The reference codes are used to answer questions specific to your license type.

If you do not have Adobe Acrobat Reader click here for a free download.

The District of Columbia also allows you to complete your credentialing application via the secure, Internet-based Universal Provider Datasource® (UPD). UPD is managed by CAQH, a not-for-profit organization working to simplify healthcare administration. The online application is identical to the printable version and free of charge to practitioners. After entering your information, you may: 1) transmit your completed application electronically to participating organizations or 2) print a hard copy to forward to non-participating organizations.

First-time UPD users will need a CAQH Provider ID in order to complete the registration process. If you have not received a CAQH Provider ID, please contact your health plan to confirm that they are participating.

Click the button above to access the UPD.

The District of Columbia Department of Insurance, Securities and Banking does not endorse or promote
the products or services offered by this website.  For further information contact us at (202) 727-8000
.