INCOMPLETE OR PARTIAL APPLICATIONS WILL NOT BE ACCEPTED.

In order for a provider application to be processed, the completed application must include all of the following documents:

• Results of the Self Query of the National Provider Data Bank. Here's the link to complete the self query of the National Practitioner Data Bank: https://www.npdb.hrsa.gov/ext/selfquery/SQHome.jsp
  We highly recommend that the self query be completed at the beginning of the process. The receipt of the self query of the National Practitioner Data Bank report may take 10-15 days to be returned to the provider office.
• Caterpillar Attestation
• Caterpillar Release of Information 
• Caterpillar PPO Healthcare NetWork Questionnaire
• Initial/New State of Illinois Uniform Health Care Credentialing and Data Collection form (pages 1-29 and A-F)
  Note: All pages requiring signatures and dates must have signatures and current dates.
• Current copy of provider’s state professional license(s)
• Current copy of controlled substance license (if applicable)
• All educational certifications (including current board certification, professional school diplomas, residency and fellowship certifications as applicable)
• Current professional liability insurance with effective and expiration dates and amount displayed per occurrence and in aggregate
• Current copy of federal DEA license (if applicable)
• Current W-9 for practice

Note: Services will be paid as out-of-network for Caterpillar  Healthcare PPO NetWork members until the credentialing process is completed and the provider is notified of their acceptance into the Caterpillar Healthcare PPO NetWork.

Fax or email the completed credentialing application to:

Fax: 309-213-2166

Email: Pr_Credentialing@cat.com

Upon completion of the credentialing process, the Caterpillar NetWork Provider Credentialing Committee will review all information and make a final determination. All applicants will be notified of the Caterpillar NetWork Provider Credentialing Committee's credentialing decision.

If you have questions, contact a member of the Provider Relations credentialing team.