Notable Timeframes
This process must be completed within 52 days and involves contract to PAR set up.
What is Medicaid Enrollment SLA?
This term refers to healthcare professionals who have signed agreements to participate in a health plan.
What are in‑network providers?
This houses individual practitioner application data forms.
What is CAQH?
This unique identifier is commonly used to uniquely identify healthcare providers.
What is an NPI?
This is the only U.S. state that can be typed using just one row of a QWERTY keyboard.
What is Alaska?
An attestation is deemed expired once it ages past this timeframe.
What is 120 days?
This process verifies a provider’s qualifications before participation in the network.
What is credentialing?
This credentialing step confirms licenses, education, and board certification directly from original sources.
What is primary source verification?
This update ensures directories reflect current locations, specialties, and demographics.
What is a provider data update?
This movie features the song “Let It Go.”
What is Frozen?
A Provider application is considered current for this amount of time.
What is 1-Year?
This agreement outlines reimbursement, participation rules, and responsibilities between a provider and a health plan.
What is a provider contract?
This recurring process ensures providers continue to meet participation standards.
What is recredentialing?
This downstream issue often results from incorrect provider enrollment or setup.
What are claims rejections or denials?
This planet in our solar system rotates clockwise, unlike most others.
What is Venus?
The timeframe for a standard voluntary contract termination effective date.
What is 180 days?
This team function ensures accurate provider information is available to members and systems.
What is provider data management?
Making updates to this via PCDM or PVDM may trigger a credentialing case, even if a current portico cycle exists.
What is Specialty Changes?
This system houses Provider contracts.
What is Icertis?
This is the largest organ in the human body by surface area.
What is the skin?
If there is not a current credentialing cycle in Portico, CenProv will generate a credentialing case within this time frame.
What is 6 months?
This network activity ensures adequate access to care for members based on time, distance, and specialty.
What is network adequacy?
This CenProv status happens when required documentation is missing or outdated during credentialing review.
What is Pending-ReturnHP?
This system feeds off of Portico Data and is responsible for downstream claims payment.
What is Amisys?
This animated TV show features characters named Homer, Marge, Bart, Lisa, and Maggie.
What is The Simpsons?