Overview
Labels are used to explain alerts or why a file was returned to a client.
Labels and Description
| Label | Explanation |
| Application: no state specific application available | Provider does not have client service area listed as primary practice state in CAQH. Unable to download required application for credentialing |
| Application: Provider Does not use CAQH | Provider does not have a CAQH application |
| Attestation Signature/Date Missing | Signature and Date Missing |
| Board: Board information needed | Board information needed to attempt verification |
| Board: Board qualification does not meet Client requirement | Provider's board certification is not accepted by client |
| Board: expired | Provider's board is expired |
| Board: Not Certified Or Eligible | Provider is not board certified |
| Board: unable to verify | Unable to verify the board the provider attested to |
| CDS COC Required | CDS license or CoC required |
| CDS : Expired | CDS is expired |
| Client requested cancellation as they completed the file | File was completed by client and checklist is no longer needed |
| Collab Agreement: MIssing duties of supervising physician | Collabrative agreement needed |
| DEA COC Required | DEA license or CoC required |
| RTC: Deceased | Returned to Client provider deceased |
| RTC: Delegated Credentialing | Returned to Client provider advised does not need to be credentialed due to delegated credentialing |
| Does Not Wish To Participate | Returned to Client: Provider no longer wishes to particapate with plan |
| Education: Institution Closed. Unable to Verify | Medical/Professional institution is closed. Unable to verify this provider's education |
| Education: Professional/Medical School Missing from Application | Provider's Medical and Professional Schooling is needed to attempt education verification |
| EDU Diploma needed for verification | Copy of diploma needed to attempt education verification |
| Expired Attestation | Attestation is expired |
| Hospital Privileges COC Required | Hospital Privileges or CoC required |
| Incomplete andros* Application | Andros Application is incomplete. |
| License: None on File/Not found | Provider has not attested to a license or the license attested to is not found. |
| License(s)- Expired | Provider's License(s) is expired. |
| Malpractice: Expired COI | Certificate of Insurance or Insurance listed on application is expired. |
| Malpractice: Limits to not meet requirement | Provider's insurance does not meet client requirement |
| Medicare Opt-Out | Provider opted out of Medicare |
| Missing Paper Application | Missing Paper Application |
| NJ Debarment Finding | There is a finding on NJ debarment |
| No Address in Service Area (Practice Location) | Provider is not practicing in Client service area |
| RTC: No Longer Affiliated/ contracted | Provider is no longer affliated with Client |
| No Longer at Practice | Provider is no longer at practice |
| RTC: No longer seeing patients | Provider is no longer seeing patients. |
| RTC: No valid contact info/No application | Unable to conduct outreach because there is no valid contact information/no application. |
| Not a Provider Type supported by andros | Andros does not credentialing this provider type |
| NPDB Finding | NPDB finding |
| NPDB: Unable to verify DOB mismatch | Unable to complete NPDB verification because the DOB in our system does not match the provider's DOB on NPDB |
| NPI is not active | Provider's NPI is inactive |
| NPI Mismatch (Discrepancy) | the NPI listed is not for the provider being credentialed. |
| OIG Finding | OIG finding |
| RTC: Per provider credentialing not required | Provider/Cred Contact advised credentialing not required. |
| RTC: Practice Closed | The practice is closed. |
| Provider has questions regarding Client | Provider is unaware of who is completing the credenitaling. Follow up is needed by the client |
| Provider Type Needs PSV rules | PSV rules need to be updated |
| Retired | Provider is retired |
| SAM Finding | SAM finding |
| Social Security Deathmaster Finding | Deathmaster finding |
| State Board Finding | State Board finding |
| Unable to access CAQH Application | Provider's application is incomplete |
| unable to download CAQH | Application is too large and we are unable to download it. The provider needs to complete a fillable CAQH. |
| Unable to Verify EDU Out of Country | Institution is outside of the country |
| Unable to verify EDU/Training | Unable to verify education |
| Yes To Disclosure Question | Provider attested yes to a disclosure question |
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