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CASH CORE Market-Based Review Form Instructions
INTRODUCTION
Per the CASH CORE Code Combinations Maintenance Process, the CASH CORE Code Combinations Task Group (CCTV) conducts two types of review
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How to fill out caqh core market-based review
How to fill out CAQH Core market-based review:
01
Log in to the CAQH ProView portal using your credentials.
02
Navigate to the "Profile" section and select the appropriate provider type.
03
Ensure that all personal and practice information is up to date and accurate. Include your contact information, practice location, and any affiliations.
04
Review the "Qualification Questions" section and answer each question honestly and accurately. These questions may inquire about your education, training, certifications, and experience.
05
Provide details about your practice, such as the services you offer, the number of patients you see per month, and any specializations or areas of expertise.
06
Update your malpractice insurance information, including dates of coverage and policy limits.
07
Verify your Medicare enrollment status and provide any required documentation, such as your National Provider Identifier (NPI) or Provider Transaction Access Number (PTAN).
08
Review your participation in other insurance networks and provide any necessary information, such as your provider ID or contract number.
09
Upload supporting documents as required, such as copies of licenses, certifications, or accreditations.
10
Submit the completed CAQH Core market-based review for evaluation.
11
Monitor your CAQH ProView account for any updates or requests for additional information.
Who needs CAQH Core market-based review?
01
Healthcare providers: Physicians, dentists, advanced practice nurses, physician assistants, and other healthcare professionals who participate in insurance networks and seek streamlined credentialing and enrollment processes.
02
Insurance companies: Organizations that require standardized provider data and credentialing information to ensure accurate and efficient network management.
03
Medical organizations: Hospitals, clinics, healthcare systems, and other medical facilities that rely on CAQH ProView as a central repository for provider data and to improve compliance with regulatory requirements.
Remember that the need for CAQH Core market-based review may vary depending on individual circumstances and contractual agreements with insurance providers. It is essential to communicate with specific insurance networks and organizations to understand their requirements and ensure compliance.
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What is caqh core market-based review?
CAQH Core Market-Based Review is a process for health plans to assess provider network adequacy.
Who is required to file caqh core market-based review?
Health plans are required to file CAQH Core Market-Based Review.
How to fill out caqh core market-based review?
Providers can fill out CAQH Core Market-Based Review online through the CAQH website.
What is the purpose of caqh core market-based review?
The purpose of CAQH Core Market-Based Review is to ensure that provider networks meet the needs of patients.
What information must be reported on caqh core market-based review?
Providers must report information on their practice location, specialty, and availability.
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