24.03.2013 Views

Re-credentialing - Ubhonline.com

Re-credentialing - Ubhonline.com

Re-credentialing - Ubhonline.com

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

<strong>Re</strong>-<strong>credentialing</strong><br />

Frequently Asked Questions<br />

RE-CREDENTIALING PROCESSES<br />

How long is the re-<strong>credentialing</strong> process?<br />

• <strong>Re</strong>-<strong>credentialing</strong> cycles average 90 - 120 days, unless otherwise required by state law.<br />

How will I know I have been re-credentialed?<br />

• Once approved, you will receive a letter. This will be sent out about 2-3 weeks after you<br />

are re-credentialed.<br />

While I am going thru the re-<strong>credentialing</strong> process, can still see UBH members?<br />

• Yes – you can still see your UBH patients, as well as to continue to receive new referrals.<br />

Why do I need to re-credential – and how often will I have to do this?<br />

• In order to renew participation with UBH, as well as meet NCQA standards, United<br />

Behavioral Health re-credentials clinicians every three years, except in Massachusetts,<br />

which requires re-<strong>credentialing</strong> every two years.<br />

When does the re-<strong>credentialing</strong> process start? Why are they sending me this information so<br />

soon?<br />

• <strong>Re</strong>-<strong>credentialing</strong> is a lengthy process, therefore we need to begin the gathering and<br />

verification of your required information 8-9 months prior to your actual NCQA required<br />

re-<strong>credentialing</strong> date. Please <strong>com</strong>plete your information as soon as you receive it to<br />

guarantee continued participation with UBH.<br />

How do you notify clinicians about their need to re-credential?<br />

• UBH contracts with Aperture, a <strong>credentialing</strong> verification <strong>com</strong>pany, who will send you a<br />

letter notifying you of your need to re-credential. You will also receive a letter from<br />

CAQH, the Council for Affordable Quality Healthcare, who will ask you to <strong>com</strong>plete the<br />

online application.<br />

CAQH, APERTURE AND INGENIX<br />

What does CAQH stand for?<br />

• Council for Affordable Quality Healthcare, is a universal application database.<br />

Are CAQH, Aperture and Ingenix all the same?<br />

• They are not, but UBH contracts with these <strong>com</strong>panies to <strong>com</strong>plete the re-<strong>credentialing</strong><br />

process. Aperture and Ingenix are the same <strong>com</strong>pany (a <strong>credentialing</strong> verification<br />

<strong>com</strong>pany). CAQH, the Council for Affordable Quality Healthcare, is a universal<br />

application database. While CAQH stores your online application, Aperture/Ingenix is<br />

the <strong>com</strong>pany that does the verifications of the information you provided. The results are<br />

then sent to UBH to <strong>com</strong>plete your re-<strong>credentialing</strong> process.


I just got a re-<strong>credentialing</strong> application from someplace called Aperture or Ingenix - is this<br />

for UBH? Is this legitimate?<br />

• Aperture/Ingenix is the same <strong>com</strong>pany. They are a <strong>credentialing</strong> verification <strong>com</strong>pany<br />

that UBH contracts with. It is a legitimate <strong>com</strong>pany. If you receive requests from them<br />

for re-<strong>credentialing</strong> materials, please respond promptly.<br />

Why is UBH using CAQH for re-<strong>credentialing</strong>?<br />

• The CAQH web-based <strong>credentialing</strong> tool streamlines the <strong>credentialing</strong> process by<br />

enabling you to <strong>com</strong>plete your <strong>credentialing</strong>/re-<strong>credentialing</strong> application online.<br />

• CAQH’s Universal Credentialing Data Source is a free service for healthcare<br />

professionals and is available 24 hours a day, 365 days a year.<br />

• The online application system allows you to save your work and return later to finish the<br />

process. Once the application has been <strong>com</strong>pleted, the system performs a <strong>com</strong>prehensive<br />

audit to check for logical errors and omissions.<br />

• Once you have a <strong>com</strong>plete application online with CAQH, future re-<strong>credentialing</strong> is<br />

quick and easy.<br />

I have <strong>com</strong>pleted my application on CAQH; do I need to <strong>com</strong>plete anything else?<br />

• Once you have <strong>com</strong>pleted your application on CAQH, you will be sent a letter by CAQH<br />

confirming this, If UBH requires further information, you will be contacted either by<br />

UBH or Aperture/Ingenix.<br />

Why am I getting letters and requests for me to fill out a CAQH application when I already<br />

have CAQH application <strong>com</strong>pleted?<br />

• This letter is to inform you that it is time for you to re-credential and that UBH needs to<br />

pull your data from CAQH. Upon receiving this letter, please verify that your application<br />

is <strong>com</strong>plete and that you have authorized UBH to view your data.<br />

I never received a re-<strong>credentialing</strong> packet. How can I get another copy?<br />

• The re-<strong>credentialing</strong> packet is now available at www.CAQH.org. We no longer send hard<br />

copy paper applications, only letters notifying you of the need to re-credential. Please<br />

visit this website in order to <strong>com</strong>plete your re-<strong>credentialing</strong> application.<br />

I called CAQH and have sent my information in, but needed to re-fax it because it was not<br />

received the first time. How do I assure that UBH has received the info?<br />

• CAQH sends letters to clinicians confirming that their application is <strong>com</strong>plete. You may<br />

confirm that your application on CAQH is <strong>com</strong>plete by logging on to your CAQH<br />

profile. If it is not <strong>com</strong>plete, please contact the CAQH help desk at 1-888-599-1771.<br />

RECREDENTIALING ADDRESSES AND DEMOGRAPHIC INFORMATION<br />

Where did you send the re-<strong>credentialing</strong> packet?<br />

• We sent letters giving instructions on how to <strong>com</strong>plete your re-<strong>credentialing</strong> packet to<br />

your re-<strong>credentialing</strong> correspondence address or to one of your practice locations.<br />

Therefore, it is important to keep your information up to date with UBH.<br />

Can I give you an address to have my future re-<strong>credentialing</strong> packets sent to?<br />

• Yes, we now have the capability to have you provide us with a specific re-<strong>credentialing</strong><br />

correspondence address. It cannot be a PO Box; it must be a physical address. It does not<br />

have to be a location you are practicing at; however, there is only one re-<strong>credentialing</strong>


address allowed per provider (not per location). This information can be updated in the<br />

Secure Transaction area of www.ubhonline.<strong>com</strong> (update practice information); or by<br />

faxing the clinician add/change application (also found in the update practice information<br />

area) to your Network Manager.<br />

I made changes about my practice on my re-<strong>credentialing</strong> application, but I do not see that<br />

they have taken effect. Why? How can I get my info updated?<br />

• Changes are not accepted through the re-<strong>credentialing</strong> application. Please contact your<br />

network manager at 1-800-711-6089 option 5, then option 4, or visit www.ubhonline.<strong>com</strong><br />

to make changes to your information.<br />

PROVIDER STATUS AND RE-CREDENIALING<br />

I was put on unavailable status. What does that mean?<br />

• You are put on unavailable status if we have not received a <strong>com</strong>pleted re-<strong>credentialing</strong><br />

application from you. When you are on unavailable status, you will not receive referrals<br />

or be able to see new patients. You may continue to see your current patients and get paid<br />

for those services. To be taken off of unavailable status, you must <strong>com</strong>plete the re<strong>credentialing</strong><br />

application. Once we have confirmed the <strong>com</strong>pletion of your re<strong>credentialing</strong><br />

application, it may take 10 business days before you status is changed back<br />

to available.<br />

My patients received letters about my being terminated for not responding to re<strong>credentialing</strong><br />

– but I did not receive any letters. Why?<br />

• UBH is required to notify your patients within 30 days of your possible inactivation date<br />

so that they have time to transition their care to an In-network provider. These letters are<br />

sent out if you have not <strong>com</strong>plied with the re-<strong>credentialing</strong> process.<br />

• UBH sends certified letters to the re-<strong>credentialing</strong> address or to a practice address. If you<br />

did not receive the re-<strong>credentialing</strong> information it may have been because we did not<br />

have a current address for you. Please contact your network manager at 1-800-711-6089<br />

option 5, then option 4, or visit www.ubhonline.<strong>com</strong> to verify/update your information.<br />

Are you going to send another letter to my patients letting them know that I <strong>com</strong>pleted my<br />

re-<strong>credentialing</strong>, and they can keep seeing me?<br />

• UBH does not send out retraction letters to your patients if they have been notified of<br />

your possible termination. It is your responsibility to keep your information updated so<br />

that you successfully receive requests for re-<strong>credentialing</strong> and <strong>com</strong>ply with these requests<br />

in a timely manner.<br />

I was terminated for not responding to re-<strong>credentialing</strong>. How do I get back into the<br />

network? Will I be effective back to when I was terminated?<br />

• Please note that requests to join the network are reviewed based on a number of factors.<br />

To request to re-join the UBH network, you will have to <strong>com</strong>plete the initial <strong>credentialing</strong><br />

process again. Please visit www.ubhonline.<strong>com</strong> to gather and <strong>com</strong>plete the required<br />

forms and then send them in to your network manager. We cannot guarantee that you will<br />

be invited to join the network again. UBH will not be able to place you back in the<br />

network from the effective date of your termination.

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!