Credentialing and Recredentialing Applications and Forms Relocated

Effective April 1, 2021, credentialing and recredentialing applications and forms will be removed from our public website and relocated to Payer Spaces within the Availity provider portal. This change is being made to add a level of security and reduce the risk of fraudulent requests. 

In addition to the relocation of the forms, the Electronic Funds Transfer (EFT) form will be replaced with the Transaction Enrollment function in Availity. This function allows providers to add a new EFT or update an existing EFT. The EFT form will no longer be accepted after April 1, 2021, and providers will be redirected to use Availity. 

Providers must be assigned either the Transaction Enrollment, Administrator or Administrator Assistant role to access the Transaction Enrollment app.

  1. Log in to Availity
  2. Click My Providers | Enrollments Center, in the top navigation bar.
  3. Click Transaction Enrollment under Multi-Payer Enrollments on the Enrollments Center page. 

Providers that don’t have an Availity account can register now.