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Requirements for joining the Kova Healthcare network

Practitioners must submit a completed, signed, and dated KOVA Healthcare Credentialing Application, along with other supporting documents identified on the Credentialing Checklist included with the application.


Requirements for participation in the KOVA Healthcare Network include:

  • A current, unrestricted California medical license to practice, issued by the appropriate licensing board.

  • Current professional malpractice liability insurance in the minimum amounts of $1,000,000 per occurrence and $3,000,000 annual aggregate.

  • A completed professional malpractice liability questionnaire, including an explanation of all claims, settlements, and open cases 

  • If applicable, a current unrestricted Drug Enforcement Agency (DEA) registration number.



Thank you for your interest in KOVA Healthcare. Please fill out a Contract Request form and return along with a w9 and a provider roster to or Fax to (559) 207-3901. Once this is received, a contract for review and a credentialing application will be sent by email to the requestor


The Council for Affordable Quality Healthcare (CAQH) allows insurance companies to use a single, uniform application for credentialing across Health plans. KOVAHealthcare prefers CAQH as a preferred partner to streamline the credentialing process.

  • If you are a CAQH participant, please complete the CAQH Participant Application PDF and submit the form to


  • A Completed Application includes:

    • Your signature and application date

    • CAQH status of “Initial Application Complete” or “Reattestation”

    • Current license

    • Education/Training to support requested specialty(ies) (or documentation that provider will complete training within 60 days of application)

    • Current Hospital Privilege information

    • Current DEA or CDS certificate in each state where services are provided

    • Explanations to questions on the application

    • Five years’ work history, in month/year format

    • Current Professional Liability Insurance


  • If you are not interested in becoming a CAQH participant, please complete the California Participating Practitioner Application (CPPA) and email to

If the requested supporting documents are missing or the documents with signature pages are dated more than three months prior to the receipt of the completed application, the Credentialing Department will contact the applicant for the missing information.

KOVA Healthcare will assign the effective date for your participating status based upon approval from the Credentialing Committee and the Contracting Department. You will not be able to see any KOVA Healthcare members until you receive the effective date of approval into the KOVA network.


For general inquiries related to the application and or contract including status updates, Provider information & Enrollment information please email:

Review Criteria
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