Provider Guide - the Culinary Health Fund

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Provider Guide October 2012 Credentialing The purposes of credentialing and recredentialing is to review and validate a practitioners’ qualifications to provide health care services for Culinary Health Fund participants. This process ensures that practitioners’ are credentialed and recredentialed consistently and in a non-discriminatory manner, in compliance with accrediting bodies, state and federals laws, rules and regulations. All providers must successfully complete our credentialing process prior to being added to our provider network. Once a provider has been added to the network, recredentialing is generally conducted every three years to assess and validate the practioner’s qualifications. The Culinary Health Fund Administrative Services, LLC uses the state of Nevada mandated credentialing and recredentialing applications which can be found on the website at www.culinaryhealthfund.org. All elements in the application must be completed and/or acknowledged. If you feel a section does not apply, you must insert “N/A”, as no section can be left blank. For your convenience, if you have an up-to-date state of Nevada application already completed, you may re-sign and re-date that application and submit it to the Culinary Health Fund Administrative Services, LLC, in-lieu of completing the new one we have provided to you. Copies of the following items must also be returned with your completed application: 1) Current license to practice 2) Certificate of Insurance (Malpractice Face Sheet) 3) DEA Registration (or Prescription Plan Designation) and CDS certificate, when applicable 4) Health Status Form and/or Designation of Credentialing Agent Form, as applicable Please return your completed application along with all other materials to the Culinary Health Fund Administrative Services, LLC at: Culinary Health Fund Administrative Services, LLC Attn: Credentialing Department 1901 Las Vegas Blvd. South, Suite 101 Las Vegas, NV 89104 Or, for more timely processing you may fax your application to: FAX: 702-892-7365 (Please always keep a copy of all the information you submit to us for review.) If you have any questions or concerns regarding the credentialing process, please contact Provider Services at 702-892-7313, option 1. 26 Culinary Health Fund Administrative Services, LLC
October 2012 Provider Guide Resources TEXT Website Some information can be accessed on the Culinary Health Fund’s website at www.culinaryhealthfund.org. Some services on the website require registration with a username and password. Simply click on “Provider log-in and sign-up” and follow the prompts to establish an account. • Claim status can be checked online with a username and password. By using the participant’s ID number and the date of service, it can be determined whether the claim has been paid, pended, or denied. Please allow at least 30 days from the date of submission before checking claims status. You can also view benefit information and updates online. • Online Provider Directory: The online Provider Directory is updated weekly. Use this directory when referring to participants and their eligible dependents to specialists or to verify that practice information is correct. If practice information is incorrect, please contact Provider Services at 702-892-7313. • Participant eligibility can also be checked online with a username and password. The website is secure, and all participant and provider information is confidential. In most cases eligibility is given for a 2 month period. • Provider updates are also available on the website. Communication sent to the network regarding updates to policies and/or procedures will be posted online for your reference. Please Note: Only one password is issued for all practices, even those with more than one office location. If you become locked out or need a new password, please contact your office account administrator. Fast and easy to use. Don’t have time to hold? www.culinaryhealthfund.org Visit our website 24 hours a day, 7 days a week to find all the updated information you need under our provider section. Culinary Health Fund Administrative Services, LLC 27
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Provider Guide - the Culinary Health Fund

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