Outreach Reasons and Making an Application Compliant

Compliant Application Requirements & Outreach Reasons

Provider Information

• Credentialing contact information
• Email/Phone/Fax
• Licenses including issued date
• NPI Number
• Date of birth
• Social Security Number
• School and graduation year

Attestation

• CAQH profile must be attested to (signed) within the past 120 days. Please go into CAQH and re-attest to your application.

Work History

• Include 5 years of work history in the work history section of your application, or, if you have worked less than 5 years, we will need work history from date of initial licensure
• Provide a complete work history in the work history section of your application - any gaps in employment greater than 6 months require an explanation
• PLEASE NOTE:
• Fellowships can be used as evidence of work history, Internships and Residency cannot. 
• You must provide an explanation in the work history section of your application if there is a gap greater than 6 months or if your employment gap was during an internship and/or residency.
• If you do not fill in the Work History section of your application and only provide an attached CV or resume, there may be a delay in your application review. 

Disclosure Questions

• Complete all disclosure questions on your CAQH profile. 
• Provide an explanation for any question answered positively.

Malpractice Insurance

• Provide current liability insurance coverage by updating the malpractice insurance section of your application with the information from your Certificate of Insurance (COI)
• You may also want to attach the COI to your application. The COI must indicate the insured entity is either the provider or the provider's practice location
• PLEASE NOTE:
• If you do not fill in the data in the Insurance section of your application and only attach the certificate of insurance, there may be a delay in your application review.
• Any malpractice coverage added to the application that is expired will be considered non-compliant and may delay your application review.

If the provider does not carry malpractice insurance, they can either:

• indicate their coverage amount is $0
• provide a letter indicating they do not have insurance and accept/demonstrate financial responsibility

Additional Outreach Reasons

First Provider Contact

• The practitioner has not completed his/her credentialing application. In order to move forward with credentialing please login to CAQH to update the practitioner's profile.

Not Authorized by Provider

• The practitioner has not given authorization to view his/her application in CAQH. In order to move forward with credentialing please login to CAQH to update your authorization settings.

Initial Outreach

• The practitioner has been sent outreach from CAQH but has not yet completed registration with CAQH.

Application Data Submitted

• The practitioner has progressed through CAQH ProView. Waiting for CAQH to complete processing application or a required document failed to upload to CAQH.
• PLEASE NOTE: If you need to check in on the status of your documents  or have them expedited, please contact CAQH directly.
  • CAQH: 888 - 600 - 9802

Returned Mail

• The registration kit mailing was returned from USPS due to poor/incorrect mailing address, practitioner no longer at address, etc.

Profile Data Submitted

• The practitioner has progressed through CAQH ProView and “attested”  but still waiting for supporting documents to be uploaded or approved.
• PLEASE NOTE: If you need to check in on the status of your documents or have them expedited, please contact CAQH directly.
  • CAQH: 888 - 600 - 9802

Initial Application Complete

• The Information has been attested to and supporting documents received.
• PLEASE NOTE: If you need to check in on the status of your documents or have them expedited, please contact CAQH directly.
  • CAQH: 888 - 600 - 9802

Alternate Outreach

• The practitioner has been messaged at a secondary location after attempts were made to primary office location.

Incomplete Application

• andros application is incomplete and must be completed in order to move forward with credentialing.