In order to participate in a health network, you must be credentialed. Completing your credentialing application and supporting documentation prior to beginning the credentialing process will ensure that you are credentialed and in-network without delays.
The health network that you are applying with will instruct you on what documentation is needed to complete your credentialing file.
If the required documentation is incomplete or missing at the time of credentialing, the process can take up to sixty days.
If the documentation you provide is determined to be non compliant or does not meet the health networks minimum requirements, the credentialing file is returned for the following reasons:
| Facility Outreach Reasons | |
| Application | Outreach Explanation |
| Outreach Application- Missing disclosure questions | Missing Disclosure Questions: Please complete all disclosure questions and provide an explanation for any questions answered adversely. |
| Outreach Application- Expired attestation | Expired Attestation: Please resubmit an application with a current attestation. |
| Outreach Application- Missing application | Missing Application: Please provide a completed application or use the links below. |
| Accreditation/Site Survey | Outreach Explanation |
| Outreach Accred/Site Survey- Missing accreditation | Missing Accreditation: Please provide a copy of your current accreditation/site survey. |
| Outreach Accred/Site Survey- Expired accreditation | Expired Accreditation: Please provide a copy of your current accreditation/site survey. |
| Outreach Accred/Site Survey- Demographic info mismatch | Accreditation/Site Survey Demographic Information Mismatch: Please confirm the demographic information as there is a mismatch in data between the facility application and accreditation document. (ie: Facility name, address and/or NPI) |
| Certificate of Insurance | Outreach Explanation |
| Outreach COI- Expired COI | Malpractice Insurance: Please provide a copy of your current malpractice insurance. |
| Outreach COI- Missing COI | Malpractice Insurance: Please provide a copy of your current malpractice insurance. |
| Outreach COI- Demographic info mismatch | Malpractice Insurance Demographic Information Mismatch: Please confirm the demographic information as there is a mismatch in data between the facility application and accreditation document. (ie: Facility name and/or address) |
| Outreach COI- Limits below requirement | Malpractice Insurance: Please provide a copy of your current malpractice insurance that meets limits as outlined by the client. |
| Outreach COI- General Liability/Umbrella | General Liability/Umbrella Liability: Please provide a copy of your current malpractice insurance that meets limits as outlined by the client. |
| Outreach COI- Professional Liability | Professional Liability: Please provide a copy of your current malpractice insurance that meets limits as outlined by the client. |
| Outreach COI- Workers Comp | Workers Compensation: Please provide a copy of your current malpractice insurance that meets limits as outlined by the client. |
| Licensure | Outreach Explanation |
| Outreach License- Missing state license | Missing State License: Please provide a current copy of your state license |
| Outreach License- Expired state license- Unable to verify | Missing State License: Please provide a current copy of your state license |
| Outreach License- State license not found- Unable to verify | Missing State License: Please provide a current copy of your state license |
| Outreach License- Missing business license | Missing Business License: Please provide a current copy of your business license |
| Outreach License- Expired business license | Business License: Please provide a current copy of your business license. |
| Outreach License- Business license not found | Business License: Please provide a current copy of your business license. |
| Outreach License- Demographic info mismatch | Licensure Demographic Information Mismatch: Please confirm the demographic information as there is a mismatch in data between the facility application and the license. (ie: Facility name, address and/or NPI) |
| NPI Validation | Outreach Explanation |
| Outreach NPI- Mismatch facility address- unable to verify | NPI Validation: Please confirm the address as there is a mismatch in data between the facility application and NPI verification. |
| Outreach NPI- Mismatch facility name- unable to verify | NPI Validation: Please confirm the facility name as there is a mismatch in data between the facility application and NPI verification. |
| CMS Verification | Outreach Explanation |
| Outreach CMS- Mismatch facility address- unable to verify | CMS Verification: Please confirm the address as there is a mismatch in data between the facility application and CMS verification. |
| Outreach CMS- Mismatch facility name- unable to verify | CMS Verification: Please confirm the facility name as there is a mismatch in data between the facility application and CMS verification. |
| W9 | Outreach Explanation |
| Outreach W9- Missing W9 | W9: Please provide a copy of the facility W9 |
| Outreach W9- Demographic info mismatch | W9 Demographic Information Mismatch: Please confirm the demographics as there is a mismatch in data between the facility application and W9 submitted. (ie: Facility name, tin and/or address) |
| CLIA | Outreach Explanation |
| Outreach CLIA- Expired CLIA | CLIA: Please provide a current copy of your CLIA certification. |
| Outreach CLIA- Unable to verify CLIA | CLIA: Please provide a current copy of your CLIA certification. |
| Outreach CLIA- Demographic info mismatch | CLIA Demographic Information Mismatch: Please confirm the demographics as there is a mismatch in data between the facility application and CLIA. (ie: Facility name and/or address) |
| CMS Verification | Outreach Explanation |
| Outreach CMS- Approval letter needed | CMS Verification: Please provide a current copy of your CMS approval letter |
| Outreach CMS- Demographic info mismatch | CMS Demographic Information Mismatch: Please confirm the demographics as there is a mismatch in data between the facility application and the documents submitted. (ie: Facility name, tin and/or address) |
| FL Medicaid ID | Outreach Explanation |
| Outreach Medicaid ID: Mismatch ID | Medicaid ID Mismatch on FL Medicaid ID verification- Please review |
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