Get the free Credentialing New Providers - Aetna Better Health

Credentialing New Providers Contact your Provider Relations Representative to initiate credentialing of new providers in your practice. Certain delegated entities and provider specialty types may

How to fill out credentialing new providers

How to fill out credentialing new providers

1. Step 1: Gather all necessary information and documents such as provider application forms, proof of education, licensing certificates, malpractice insurance documentation, and professional references.
2. Step 2: Complete all sections of the credentialing application accurately and thoroughly, providing any required supporting documentation.
3. Step 3: Submit the completed credentialing application along with all supporting documents to the credentialing department or organization.
4. Step 4: Follow up with the credentialing department to ensure the application is being processed and to provide any additional requested information.
5. Step 5: Await the review and approval process conducted by the credentialing committee.
6. Step 6: Once approved, ensure the new provider has completed any necessary orientation or training programs required by the organization.
7. Step 7: Update necessary systems and databases with the new provider's information, such as EMR systems, insurance networks, and provider directories.
8. Step 8: Communicate the successful credentialing of the new provider to relevant parties, such as staff members, patients, and referring providers.

Who needs credentialing new providers?

1. Healthcare organizations such as hospitals, clinics, and medical practices that are looking to expand their provider network.
2. Insurance companies or managed care organizations that want to add new providers to their network.
3. Credentialing agencies or consultants who assist healthcare organizations in the provider credentialing process.
4. Professional associations or licensing boards responsible for verifying and approving providers' credentials in a specific field.
5. Government agencies or programs that require provider credentialing to ensure the quality and safety of healthcare services.

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What is credentialing new providers?

Credentialing new providers is the process of verifying the qualifications and abilities of healthcare professionals before allowing them to join a healthcare network or practice.

Who is required to file credentialing new providers?

Healthcare organizations, such as hospitals, clinics, and insurance companies, are typically responsible for credentialing new providers.

How to fill out credentialing new providers?

Credentialing new providers involves completing a detailed application form, submitting supporting documentation, and undergoing a thorough review process.

What is the purpose of credentialing new providers?

The purpose of credentialing new providers is to ensure that healthcare professionals meet the necessary standards for competence, professionalism, and ethical behavior.

What information must be reported on credentialing new providers?

Information such as education, training, licensure, certification, work history, malpractice history, and references must be reported on credentialing new providers.