Archived Processes

MedPass Application Process (DE, file import, provider populates)

Providers are required to complete their MedPass application and Attest within CheckMedic.

Recred Frequency

3 years

Account Manager

Outreach

Items Needed: Cannot add to CS Outreach for any MP Types. If items are missing or required to verify, close order as Unable to Verify'.

Verification Attempts Requirements (Time Period is Calendar days/weeks, not Business days/weeks) 

Verification Attempts Requirements: Require (3) attempts be made to verify over the course of (2) weeks. Can close out as 'Unable to Verify' after (3) attempts are made, but NOT before (2) weeks after the MedPass submitted date.

Fees (Passthrough)

Passthrough Fees are approved.

Personal Information (Incorrect)

If Name, SSN or DOB are incorrect, have a lead reach out to the Account Manager.

Board Certs

Board Cert - Verified for all MP Types, except those with a MP Type of NURSE. (Not required to have, but must be verified if provided.

*No outreach if those MP Types do NOT provide a BC, or for any required items to verify.

Active Board Certs must be verified within (120) days of MedPass Release Date.

Attestation - If the Attestation is required and is missing or expired, follow the Missing Attestations/PII Process

Attestation - signed by provider on MedPass.

Must have signed CM Attestation signed within 305 days of Release Date. If Attestation is OLDER than 305 days, place provider on CS Outreach. MedPass should be placed on HOLD until Attestation is within 305 days, even if outreach attempts are maxed.

MedPass Application Process (DE, file import, provider populates)

Providers are required to complete their MedPass application and Attest within CheckMedic.

Recred Frequency

3 years

Account Manager

Jocelyne Wood

Outreach

Provider Outreach Attempts: Require (3) attempts be made to verify over the course of (2) weeks.

Special Outreach Process: The client would like to be notified if the provider does not respond to the outreach requests for information, after the (3) attempts are made. If the outreach is archived, please add the provider to Michelle Washington's MP Account Manager Outreach tab, and she will notify DCSN directly. We cannot close out the verification or release the MedPass until Michelle Washington has provided direction from the client.

Verification Attempts Requirements (Time Period is Calendar days/weeks, not Business days/weeks) 

Verification Attempts Requirements: Require (3) attempts be made to verify over the course of (2) weeks. Can close out as 'Unable to Verify' after (3) attempts are made, but NOT before (2) weeks after the MedPass submitted date.

Fees (Passthrough)

Passthrough Fees are approved.

Personal Information (Incorrect)

If Name, SSN or DOB are incorrect, add provider to outreach to request correct info.

Board Certs

Board Cert - Board Certification is NOT required for DCSN providers. If the provider is Board Certified, the certification must be verified.

Active Board Certs must be verified within (120) days of MedPass Release Date.

Attestation - If the Attestation is required and is missing or expired, follow the Missing Attestations/PII Process

Attestation - signed by provider on MedPass.

Must have signed CM Attestation signed within 305 days of Release Date. If Attestation is OLDER than 305 days, place provider on CS Outreach. MedPass should be placed on HOLD until Attestation is within 305 days, even if outreach attempts are maxed.

MedPass Application Process (DE, file import, provider populates)

API

Account Manager

Outreach

Provider Outreach Attempts: Require (3) attempts be made to verify over the course of (2) weeks. Can close out as 'Unable to Verify' after (3) attempts are made, but NOT before (2) weeks after the MedPass submitted date.

Fees (Passthrough)

Board Certs

All MedPass Types

MedPass Application Process (DE, file import, provider populates)

Providers are required to complete their MedPass application and Attest within CheckMedic. Data is also pulled from file imports.

Recred Frequency

3 years

Account Manager

Jocelyne Wood

Outreach

Provider Outreach is Not approved. We will need to reach out to the Account Manager, Jocelyne Wood, to contact the client for all items needed.

Verification Attempts Requirements (Time Period is Calendar days/weeks, not Business days/weeks) 

Verification Attempts Requirements: Require (3) attempts be made to verify over the course of (2) weeks. Can close out as 'Unable to Verify' after (3) attempts are made, but NOT before (2) weeks after the MedPass submitted date.

Fees (Passthrough)

Passthrough Fees (only some are approved) 

Education: NSCH fees are approved and school fees up to $75 are approved

Board Certs: Passthrough fees are approved for Board Cert's up to $50. If Fee is greater than $50, we will need client approval.

Personal Information (Incorrect)

If Name, SSN or DOB are incorrect, reach out to Account Manager to request correct info.

Board Certs

Board Certs -  Verified (Not required to have, but must be verified if provided.

Can use BC (Verified/Active) as highest level education

Active Board Certs must be verified within (120) days of MedPass Release Date.

American Board of Family Medicine (ABFM): Board certification verifications verified through ABFM do not always include a full certification date or an expiration date. If the full Effective/Certification Date is listed on the verification, that date should be entered within the order for the Effective Date and Certification Date. The Recertification Date should also be entered, if the full date is supplied on the verification. If the full Effective/Certification Date is not listed on the verification, we will use February 15th for the month and day and the Certification Year listed on the verification. Example Issue Date: For an ABFM board cert verification with a Certification Year of 2022, we will capture the Effective/Certification Date as 2/15/2022. For the Expiration Date, we will use February 15th for the month and day and the following year for the expiration date, in order to monitor their Board Certs on an annual basis. Example Expiration Date: For an ABFM board cert verification completed on 3/29/2023, we will capture the expiration date as 2/15/2024.

American Board of Internal Medicine (ABIM): Board certification verifications verified through ABIM do not include a full certification date or an expiration date. For the Effective/Certification Date we will use April 1st for the month and day and the Certification Year listed on the verification. Example Issue Date: For an ABIM board cert verification with a Certification Year of 2022, we will capture the Effective/Certification Date as 4/1/2022. For the Expiration Date, we will use April 1st for the month and day and the following year for the expiration date, in order to monitor their Board Certs on an annual basis. Example Expiration Date: For an ABIM board cert verification completed on 3/29/2023, we will capture the expiration date as 4/1/2024.

Attestation - If the Attestation is required and is missing or expired, follow the Missing Attestations/PII Process

Attestation - Must be signed by provider on MedPass if due for Initial Cred or Recred. Must have signed CM Attestation signed within 305 days of Release Date.

MedPass Application Process (DE, file import, provider populates)

File Import and DE completed by us using WA Application from OneHealth Port.

Recred Frequency

3 years

Account Manager

Kathy Garcia

Outreach

Please do NOT add for outreach and let Kathy Garcia know if anything is missing.

Verification Attempts Requirements (Time Period is Calendar days/weeks, not Business days/weeks) 

Requires (3) attempt made with at least (1) attempt made weekly, before closing order as UTV. Can close out as "Unable to Verify' after (3) weekly attempts are made, but NOT before (2) weeks after the MedPass submitted date. 

Fees (Passthrough)

Passthrough Fees are approved.

Personal Information (Incorrect)

If Name, SSN or DOB are incorrect, notify Kathy Garcia 

Board Certs

Board Cert -  Verified (Not required to have, but must be verified if provided.

Active Board Certs must be verified within (120) days of MedPass Release Date.

Attestation - If the Attestation is required and is missing or expired, follow the Missing Attestations/PII Process

Attestations - Found in WA application. Attestations must be signed within 305 days of the Release Date.

MedPass Application Process (DE, file import, provider populates)

Providers are required to complete their MedPass application and Attest within CheckMedic.

Recred Frequency

2 years

Account Manager

Doug Park

Outreach

Provider Outreach Attempts: Require (3) attempts be made to verify over the course of (2) weeks. Can close out as 'Unable to Verify' after (3) attempts are made, but NOT before (2) weeks after the MedPass submitted date.

Verification Attempts Requirements (Time Period is Calendar days/weeks, not Business days/weeks) 

Requires (3) attempt made with at least (1) attempt made weekly, before closing order as UTV. Can close out as "Unable to Verify' after (3) weekly attempts are made, but NOT before (2) weeks after the MedPass submitted date. 

Fees (Passthrough)

Passthrough Fees are approved.

Personal Information (Incorrect)

Board Certs

Board Cert -  Verified

Walmart does NOT have a requirement for their MC Providers to be Board Certified, unless they are have a MP type of MC Psychiatric NP – Telemedicine.

REQUIREMENT: MC Psychiatric NP – Telemedicine are required to enter an active Board Certification in Family Practice (include image) or Adult Heath (include image) AND Pediatrics (include image) or Psychiatric Mental Health (include image)

American Board of Internal Medicine (ABIM): Board certification verifications verified through ABIM do not include a full expiration date. As of 4/10/2023 for Walmart Physicians, for the Expiration Date, we will use April 1st for the month and day and the following year for the expiration date, in order to monitor their Board Certs on an annual basis. Example Expiration Date: For an ABIM board cert verification completed on 3/29/2023, we will capture the expiration date as 4/1/2024.

American Board of Family Medicine (ABFM): Board certification verifications verified through ABFM do not always include a full certification date or an expiration date. If the full Effective/Certification Date is listed on the verification, that date should be entered within the order for the Effective Date and Certification Date. The Recertification Date should also be entered, if the full date is supplied on the verification. If the full Effective/Certification Date is not listed on the verification, we will use February 15th for the month and day and the Certification Year listed on the verification. Example Issue Date: For an ABFM board cert verification with a Certification Year of 2022, we will capture the Effective/Certification Date as 2/15/2022. For the Expiration Date, we will use February 15th for the month and day and the following year for the expiration date, in order to monitor their Board Certs on an annual basis. Example Expiration Date: For an ABFM board cert verification completed on 3/29/2023, we will capture the expiration date as 2/15/2024.

* Board Cert Monitoring- All Board Certifications must be monitored for renewal upon expiration. All Active Board Certifications must be re-triggered and re-verified no later than (30) days prior to the expiration date. If not renewed at (30) days prior to the expiration date, all Board Certifications will need to be re-verified within (1) business day after the expiration date.

Active Board Certs must be verified within (120) days of MedPass Release Date.

Attestation - If the Attestation is required and is missing or expired, follow the Missing Attestations/PII Process

Attestation - signed by provider on MedPass. Must have signed CM Attestation signed within 305 days of Release Date.

MedPass Application Process (DE, file import, provider populates)

Providers are required to complete their MedPass application and Attest within CheckMedic.

Recred Frequency

2 years

Account Manager

Doug Park

Outreach

Provider Outreach Attempts: Require (3) attempts be made to verify over the course of (2) weeks. Can close out as 'Unable to Verify' after (3) attempts are made, but NOT before (2) weeks after the MedPass submitted date.

Verification Attempts Requirements (Time Period is Calendar days/weeks, not Business days/weeks) 

Requires (3) attempt made with at least (1) attempt made weekly, before closing order as UTV. Can close out as "Unable to Verify' after (3) weekly attempts are made, but NOT before (2) weeks after the MedPass submitted date. 

Fees (Passthrough)

Passthrough Fees are approved.

Personal Information (Incorrect)

If Name, SSN or DOB are incorrect, add provider to outreach to request correct info.

Board Certs

Board Cert -  Verified

* REQUIREMENT (updated 3/29/2024): Medical Assistants for Walmart require at least one Medical Assistant Board Certification with any of the following (5) Boards: 

* National Center for Competency Testing (NCCT)

* American Association of Medical Assistants (AAMA)

* American Medical Technologists (AMT)

* National Healthcareer Association (NHA)

* American Allied Health (AAH)

* If the Medical Assistant does not have a verified active Medical Assistant Board Cert through NCCT, AAMA, AMT, NHA or AAH, provider outreach must be done before the MedPass can be released. Request that a board cert with NCCT, AAMA, AMT, NHA or AAH be provided to verify, in order to meet this Board Cert requirement for Walmart.

* Board Cert Monitoring- All Board Certifications must be monitored for renewal upon expiration. All Active Board Certifications must be re-triggered and re-verified no later than (30) days prior to the expiration date. If not renewed at (30) days prior to the expiration date, all Board Certifications will need to be re-verified within (1) business day after the expiration date.

Attestation - If the Attestation is required and is missing or expired, follow the Missing Attestations/PII Process

Attestation - Medical Assistants may or may not have a signed Attestation or Release of Information. It is not a requirement to sign any documents. 

MedPass Application Process (DE, file import, provider populates)

Providers are required to complete their MedPass application and Attest within CheckMedic.

Recred Frequency

2 years

Account Manager

Doug Park

Outreach

Provider Outreach Attempts: Require (3) attempts be made to verify over the course of (2) weeks. Can close out as 'Unable to Verify' after (3) attempts are made, but NOT before (2) weeks after the MedPass submitted date.

Verification Attempts Requirements (Time Period is Calendar days/weeks, not Business days/weeks) 

Requires (3) attempt made with at least (1) attempt made weekly, before closing order as UTV. Can close out as "Unable to Verify' after (3) weekly attempts are made, but NOT before (2) weeks after the MedPass submitted date. 

Fees (Passthrough)

Passthrough Fees are approved.

Personal Information (Incorrect)

If Name, SSN or DOB are incorrect, add provider to outreach to request correct info.

Board Certs

Board Cert -  Verified

REQUIREMENT: NP's are required to enter an active Board Certification in Family Practice (include image) or Adult Heath (include image) or Pediatrics (include image).

* Board Cert Monitoring- All Board Certifications must be monitored for renewal upon expiration. All Active Board Certifications must be re-triggered and re-verified no later than (30) days prior to the expiration date. If not renewed at (30) days prior to the expiration date, all Board Certifications will need to be re-verified within (1) business day after the expiration date.

Active Board Certs must be verified within (120) days of MedPass Release Date.

Attestation - If the Attestation is required and is missing or expired, follow the Missing Attestations/PII Process

Attestation - signed by provider on MedPass. Must have signed CM Attestation signed within 305 days of Release Date.

MedPass Application Process (DE, file import, provider populates)

Data Entry is performed from CAQH application; captured directly from UUHP CAQH logins. 

Recred Frequency

3 years

Account Manager

Jocelyne Wood

Outreach

* Add to CS & CM - UUHP Outreach (Processing) if provider outreach is required for items needed during data entry or for the release.

* Add a MedPass Note (select Production):  In Outreach: <Insert reason for outreach>.

* UUHP Outreach (Processing) Provider Outreach Attempts: Requires (3) attempts be made to verify over the course of (2) weeks.

* If outreach is unsuccessful to obtain missing items after (3) attempts, do not release the MP as the account manager needs to contact UUHP for assistance. Update the MedPass status to AM/Client Review and add max attempts note to MedPass. Add the MP details to Jocelyne Wood's tab on CheckMedic Outreach.

Verification Attempts Requirements (Time Period is Calendar days/weeks, not Business days/weeks) 

Education and Medical Training is not verified

Fees (Passthrough)

Passthrough Fees are approved for Wanted BC's

Personal Information (Incorrect)

All Professions: Check CAQH if Personal Info is missing and add to the MedPass

We do not need to check Name, SSN or DOB against Piidat per UUHP's request. Please use what is reflected on the application

Board Certs

Board Certs - Verified for all Licensed MP Types if supplied in CAQH

* Certifacts is approved for ABMS Boards for this client.

* As of 3/28/2023, it has been approved by UUHP to use the re-verification date listed on the ABMS/Certifacts verifications as the expiration date within the Board Cert verification.

* Must check all Board Cert verification PDFs for current specialties and subspecialties listed as active with the applicable Board Certifying Organization. The following scenarios apply to this process:

• If a specialty or subspecialty returns on a verification as active and that specialty is not listed as a Board Cert entry, the Board Cert processor must add a Board Cert for that specialty to the MedPass. They must also ensure that the Board Cert order generates to be verified for the active specialty. Inactive sub-specialties don't need to be added. The MedPass Releasers are also responsible for ensuring that the additional specialties have been verified.

• If the provided specialty listed on CAQH cannot be found, the Board Cert order can be returned as Not Found. If there are additional specialties returned on a verification as active with the applicable Board Certifying Organization, that specialty must be added and verified. The Board Cert processor must add a Board Cert for that specialty to the MedPass. They must also ensure that the Board Cert order generates to be verified for the active specialty. The MedPass Releasers are also responsible for ensuring that the additional specialties have been verified.

  • Example in this scenario: The CAQH app lists the specialty as Hospitalist for their Board Certification, but the ABMS verification only lists an active certification under the Internal Medicine Specialty. We would return the Hospitalist specialty as Not Found. The Internal Medicine specialty with the American Board of Internal Medicine would also need to be added as an additional Board Cert entry, to then be verified as Active.ties don't need to be added.

* NP's: Check CAQH if missing. Check ANCC and AANP

* PA's: Check CAQH if missing. Check NCCPA

* UT Behavior Analysts should have Board Certified Behavior Analyst (BCBA) BC. Check CAQH if missing. Check BACB Certificant Registry

* Home City, State and Zip Code must be entered under Personal Info to generate order. Add those fields if missing and re-submit MP to generate.

* If the provider's Board Cert is not found under the practice state, try searching by the state in which their education was completed.

* Active Board Certs must be verified within (120) days of MedPass Release Date.

Attestation - If the Attestation is required and is missing or expired, follow the Missing Attestations/PII Process

Attestation - must have a current Attestation in CAQH, that is not listed as Expired.

* BEFORE releasing a MP, check that the Attestation date on the uploaded CAQH documents matches the current Attestation date listed in CAQH. If they have been updated since the CAQH documents were uploaded to the MedPass, you'll need to download the combined docs again in CAQH and re-upload to the MP Documents.

* HCU only has been credentialed for UUHP and not in Recred cycle 305 days, all other scenarios are 120 days

Attaching Attestation to MP:

1. Download the "Standard Authorization, Attestation and Release" document from the downloadable docs in CAQH. 

2. Enter the the "Last Attestation" date on the right top corner of the document into the "Attestation Date" in the MedPass.

3. Upload the Attestation PDF to the "Attestation Document" section in the Medpass. 

4. Click Submit Attestation. 

*If there is no "Standard Authorization, Attestation and Release" Document you can upload the First page of the Provider summary in its place and highlight the last attestation date.