15
• Providers may make available and/or distribute Bravo Health marketing materials and display posters
in accordance with and subject to Medicare Marketing Guidelines;
• Providers may not make available, accept or distribute plan enrollment applications or offer
inducements to enroll in a specific plan; and
• Providers may not offer anything of value to induce a prospective Member to select them as their
Provider.
PROVIDER CREDENTIALING AND PARTICIPATION
Providers must be credentialed by Bravo Health according to the following guidelines:
Provider Status Procedure
New to plan, not
previously credentialed
Practicing in a solo practice Requires a signed contract and
initial credentialing which may
include a site visit depending upon
Provider’s specialty*
New to plan, not
previously credentialed
Joining a contracted group
practice
Requires initial credentialing;
however, a site visit is not be
required regardless of specialty.
Already contracted and
credentialed
Leaving a group practice to
begin a solo practice
Does not require credentialing;
however a new contract is required
and a new office location may
require a site visit depending upon
Provider’s Specialty*
Already contracted and
credentialed
Leaving a group practice to
join another contracted
group practice
Does not require credentialing and
no site visit is required regardless of
specialty.
Already contracted and
credentialed
Leaving a group practice to
join a non-contracted group
practice
The Provider’s participation is
terminated unless non-contracted
group signs a contract with Bravo
Health.
* Primary Care and OB/GYN offices require site visits
PROVIDER & ALLIED HEALTH PRACTITIONERS CREDENTIALING CRITERIA
REQUIRED INFORMATION
1) Completed Bravo Health, Texas Standard or CAQH application with a signed and dated Bravo Health
Certification and Attestation form.
a) If you answer yes to any of the questions, supply all additional information.
b) If you answer yes to the malpractice history question, please supply for each case:
1. Date of alleged malpractice
2. A brief description of the nature of the case and alleged malpractice
3. A statement describing your role in the case
4. Current status of case, including any settlement amount
