Before participating in a health network, you must be credentialed. Completing your credentialing application prior to beginning the credentialing process will ensure that you are credentialed and in-network without delays.
The health network will instruct you on whether you need to the CAQH profile/application or andros application. If you need to use CAQH, please sign in to your account by clicking here. If you do not already have a CAQH profile, please register for an account. Practitioners with updated CAQH applications prior to beginning the credentialing process, can be credentialed within one week. If the required documentation is incomplete or missing at the time of credentialing, the process can take up to sixty days.
If you need to use the andros application, please follow the instructions provided in your original invitation that was sent to your email.
Incomplete or non-compliant applications will delay acceptance into the network.
| Compliant Application Requirements & Outreach Reasons | |
Requirement |
What do I do? |
| 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. |
| Disclosure Question: Colorado Application TB Question 4 | CO State Application TB Disclosure Questions answered without supporting documentation or explanation. Upload TB results or provide explanation. |
| Disclosure Question: Georgia Application Health Status Question 2 | Georgia State Application Health Status Disclosure question answered adversely - Response updated or explanation provided. |
| Disclosure Question: Colorado Application Health Status Question 3 | CO Health Status Disclosure question answered adversely - Response updated or explanation provided. |
| 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 | |
| Outreach Reason | What do i do? |
| 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, and supporting documents submitted. Please complete the CAQH application to finish the process. |
| Alternate Outreach | The practitioner has been messaged at a secondary location after attempts were made to primary office location. |
| Board: Copy of ANCC required | Copy of ANCC board needed |
| Board: information needed | An active board ID or a copy of a board is required for verification |
| Board: Need Board ID | An active board ID or a copy of a board is required for verification |
| CDS: expired | CDS Is expired - Please submit an active CDS Certificate for all required practice states or a waiver request if this provider does not prescribe prescription medication, |
| CDS: No CDS license provided for required practice states | CDS is required for all attested practice states - Please submit an active CDS Certificate for all required practice states or a waiver request if this provider does not prescribe prescription medication, |
| CDS: required | Please submit an active CDS Certificate for all required practice states or a waiver request if this provider does not prescribe prescription medication, |
|
CLIA: Expired
|
CLIA certificate on file has expired. Please submit an updated, valid certificate. |
| CLIA: Missing | Laboratory testing is indicated for this provider, but no CLIA certificate is on file. Please upload a copy of the current certificate to maintain compliance |
| Collab Agreement: MIssing duties of supervising physician | Collab agreement is missing duties of supervising physician. Agreement is required to include the duties of the provider and/or supervising physician and resubmit. |
| Collab Agreement: Missing License # for provider or supervising physician | Collab agreement is missing license # for provider and/or supervising physician. Agreement is required to be updated to include the license number for the provider and/or supervising physician and resubmit. |
| Collab Agreement: Missing Practice Location | Collab agreement is missing practice location. Agreement is required to be updated to include practice locations and resubmit. |
| Collab Agreement: updated signatures needed | Collab agreement is missing updated signatures. Agreement is required to be updated with signatures and resubmit. |
| Collaborative Agreement Required | Based on your current State License, you're required to have a Supervising Agreement/Collaborative Agreement with a supervising physician, and the client requires that we collect this document. Please ensure the following information is included: (1) license numbers for the provider and/or supervising physician, (2) duties of the supervising physician, (3) practice locations, (4) provider and supervising physicians' signatures dated within the required timeframe |
| DEA: License needed for all practice locations | A DEA is required for all active practice locations attested or a DEA waiver form is required |
| DEA: expired | Attested DEA is found to be expired. Active DEA license or DEA waiver is required. |
| DEA: No DEA license provided for all active practice states | DEA for all active practice states client requires is missing. Please submit DEA license or DEA waiver. |
| Education: Diploma needed for verification | Please provide a copy of diploma to complete education verification |
| Education: ECFMG # needed | If you have an ECFMG number, please submit. If you do not have a ECFMG number please provide email contact information for foreign education verification |
| Education: Medical/Professional School missing from application | Please update application for include medical/professional school information for education verification |
| Education: Release Needed | Please submit updated release form for education verification. |
| Incomplete andros* application | Andros application is incomplete and must be completed in order to move forward with credentialing. |
| License Type Mismatch: Provider Type and License type do not Match on CAQH | Mismatch of provider type of application and license type. |
| License: Expired | License was found to be expired, please provide an active license number |
| License: None on File/Not found | No license attested to in application or license was not found - Please submit an active license number for verification |
| Missing Hospital Privileges | Hospital privileges in participating hospital is missing from application |
| License: Not in Service Area | Please provide a current state license within the client's service area |
| No Practice Location in Service Area | Please advise if you no longer practice in the client's service area. If you do, please update your application locations. |
| NPI Mismatch | Please verify the NPI listed in your application is correct. |
| Peer References: 3 Peer References Needed | Please provide First and Last name, email and phone number for 3 Peer References. |
| AMA/AOA: Information needed to verify membership | Please provide AMA/AOA information so we may complete the verification. |
| Board: Release Needed | Please provide a recent signed release for board verification |
| Education: Residency Information Required | Please update application to include your residency information and/or provide a copy of your residency certification. |
| Release: State specific release required | Please complete state specific release |
| Education: Unable to verify foreign education | In order to verify your education please provide contact information/email address for foreign program administrator/director. |
| Hospital Privileges: Missing ACLA Hospital Privileges | Please log into CAQH to add admitting privileges for a Louisiana hospital. |
| Education: FCCPT documentation required | Please provide a copy of your FCCPT form for education verification |
We will contact you via email, phone or fax to address incomplete or non-compliant applications. If you have any questions, you may contact us here.
Watch the video below to learn more about what makes an application compliant.
Have more questions? Get help here.
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