MISC credentialing
A document that identifies a specific malpractice insurance carrier
Certificate of Insurance
provider 48 hours
facility 72 hours
How long do you go without reaching out to a provider and/ or a facility?
This database tracks adverse licensure actions, malpractice payments, and professional review actions against healthcare providers.
NPDB
Who do you go to for Background Checks and Drug Screens?
Savannah and Hailey
Credentialing and licensing are the same thing.
False
Improper, illegal, or negligent professional activity or treatment, especially by a medical practitioner, lawyer, or public official
malpractice
60-90 days for a hospital and ASC could be 2-30 days
How long does the credentialing process usually take?
This unique 10-digit identification number is required by HIPAA for all healthcare providers.
NPI
1. Providers Name and credentials
2. Name and address of facility
3. Retro and Start Date
4. NPI and License #
What information is needed to request a COI?
A provider can have an active state license but still have an incomplete credentialing file.
True
A person who can speak on the provider's behalf regarding their scope of practice or interpersonal skills.
References
1 year
How long is a Radar App good for?
National Board of Certification and Recertification for Nurse Anesthetists
What is NBCRNA
Nursys and BON for that state
Where are two places you can find a providers license number?
A provider's CV alone is considered primary-source verification
False
What information/or documents are required to run a background check and drug test?
Release forms and phone number and email address
2-3 years
How often do providers get recredentialed at facilities.
This government portal is used by providers to enroll and manage their Medicare billing data online
PECOS
Recruiter: Can you just work on this provider for me?
No it must be assigned by Terry
A DEA registration automatically replaces the need to verify state controlled-substance requirements.
False
1. First two characters must be uppercase letters
2. Sum the first, third and fifth digits
3. Sum the second, fourth and sixth digits
4. Double the number in step 3
5. Sum the numbers from step 2 and 4
6. If the last digit of the number is the same as the last digit of the number obtained in step 5, the number is considered valid.
What is how do you verify a DEA number is valid
30 days
A gap longer than __ days requires an explanation
Universal Application Tool used to reduce paperwork and streamline credentialing for healthcare professionals, including mental health professionals
CAQH
A _ is a business organization that provides administrative and operational services to medical practices or healthcare providers.
A _ is primarily focused on credentialing and verification.
MSO and CVO
Documentation and communication are both critical components of a successful credentialing process.
True