Good morning! We are window shopping for software to manage our Credentialing; mostly provider data management and payer enrollment pieces, for 150-200 behavioral health providers. Linkage with CAQH and/or UKG a plus. Anyone familiar or use a product they endorse?
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Wiki Credentialing software
- Thread starter cbreeze@horizon-health.org
- Start date
olgak@wchsb.com
New
we are using credyapp.com to run practice of 300+ doctors, its doesnt connect to caqh but it works efficiently to help manage contracts, revalidation, docs documents and tasks for everyday.
Question regarding CAGH ProView for credentialing. If an insurance company is linked to CAQH when the CAQH application is completed and you allow access to insurance companies, is there anything additional that you need to provide to the insurance company directly? or are you done and once validated via CAQH you can begin filing claims? Does CAQH ask if you want to be credentialed in or out of network?
rthomas@impcna.com
Expert
It depends on the payer. There are several payers that I deal with that use CAQH, but they also have a few of their own forms that they want completed. You have to make sure that the provider is added to your group contract(s) or has their own individual contract. There is a lot that goes into credentialing. It is best to reach out to each payer separately.