Embedded Files
If there are items needed to complete credentialing on a MedPass, check Client Requirements under the Outreach column to determine if direct provider outreach is approved, or if we are required to reach out to the client directly.
CM Outreach - If Outreach is approved to contact the provider or client, login to JIRA to submit a ticket on this board.
Before submitting an Outreach ticket, make sure to search by the provider's name, in the search field on the CM Outreach board.
If a ticket already exists for that MedPass, you will need to add additional information needed to the existing ticket, even if you did not submit that ticket.
If an outreach ticket does not already exist, a new ticket can be submitted.
Fresenius Missing BCs - Outreach - The following Physician Professions require a Board Cert entry with the American Board of Internal Medicine for both Internal Medicine listed as the Specialty and a separate Board Cert entry with Nephrology listed as the Specialty.
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians - Internal Medicine - Nephrology
Allopathic & Osteopathic Physicians - Pediatrics - Pediatric Nephrology
The following exceptions apply to this process:
Fellows: Providers with the Fellow job code listed on their active LER may not be boarded in the Internal Medicine or Nephrology specialties, as they are currently in their Fellowship Training program. If they are missing the Internal Medicine Board Cert or Nephrology Board Cert and they have marked either requirement as Does Not Apply, provider outreach is not required for that specialty.
Pediatric Nephrologists: If a Pediatric Nephrologist provides their American Board of Pediatrics Board Cert to verify, they are not required to have the Internal Medicine Board Cert or Nephrology Board Cert. Outreach is not required to request either Board Cert, if missing in this scenario.
Nephrology (IM) Specialties: If a provider enters the Board Cert Specialty as Nephrology (IM) and the Nephrology requirement is not checked off, outreach is not required to request the Nephrology Board Cert as long as a verification for the Nephrology specialty has generated.
When assigned to work on Fresenius Missing BCs - Outreach, the following process should be followed:
If a Physician with a configured Profession listed above is missing the Internal Medicine or Nephrology Board Cert entry, they will be listed on this tracker with the specialty that is missing in the Has Both Certs? column. Open the MedPass to confirm that the missing BC has not been added. If there is now an entry for Internal Medicine and a separate entry for Nephrology, update the status to Has both BCs. If it is still missing, proceed to the next step.
Make sure to review the following exceptions listed above, before submitting an Outreach ticket.
Before submitting an Outreach ticket, make sure to search by the provider's name, in the search field on the CM Outreach board.
If a ticket already exists for that MedPass, you will need to add additional information needed to the existing ticket, even if you did not submit that ticket.
If an outreach ticket does not already exist, a new ticket will need to be created following the steps listed below in Creating a New Ticket. Due to time constraints, it is approved for these Fresenius Physicians to NOT do a full MedPass review for other missing items. Only the missing Board Cert will need to be included in new tickets created from this task.
Once the outreach ticket is created, please add a production MedPass note and include the link to the ticket, along with what is needed for outreach.
Add the applicable info to the tracker for the following fields: CM OUT Ticket Made Date, Ticket URL and Processor.
Once the ticket has been created, the Outreach team will need to follow the standard process for attempts listed on Outreach Workflow (Standard).
All outreach attempts for missing Board Certs should not have direct provider outreach. Please only contact the following Fresenius Admin, if outreach is needed:
Stephanie Dejesus
Email: Stephanie.Dejesus@freseniusmedicalcare.com
Creating a New Ticket: To create a new ticket, go to CM Outreach.
Click on Create, next to Apps, or +Create Issue in the New Request lane.
2. The Project of CM Outreach (CMOUT) and Issue Type (Standard) will auto-populate in those fields and should be left as is for all clients.
3. Summary: Add the Provider's Full Name - Client Name
4. Add info to the following Fields. All fields must have data entered in order for outreach to begin. If an email address or phone number is not available, then that field can be left blank. We need at least one method of contact (email or phone number) to do outreach.
Client: <select client name from the drop-down list>
Provider ID: <insert Company ID listed on the MP summary under Company Info> *Must be added for Fresenius providers.
Provider Name: <insert Provider's Name from the MP summary>
Contact E-mail: <Insert email address listed on the MP summary under the Provider's name, for all clients approved to do direct provider outreach.>
*If not on the MedPass, add info from CAQH (if applicable).
*ADVANTUM: For the following Advantum sub-clients, please only email the client at the email addresses listed below:
Baptist Health: Tarah Vanhooser - tvanhooser@advantumhealth.com
Functional Pathways: Tarah Vanhooser - tvanhooser@advantumhealth.com
HealthPro Heritage: hphcredentialing@advantumhealth.com
Innovista-Texas: Tarah Vanhooser - tvanhooser@advantumhealth.com
Keplr Vision: Tarah Vanhooser - tvanhooser@advantumhealth.com
Kidney Care and Transplant Services of N.E.: Tarah Vanhooser - tvanhooser@advantumhealth.com
Planned Parenthood of FL: Tarah Vanhooser - tvanhooser@advantumhealth.com
San Bernardino County: Tarah Vanhooser - tvanhooser@advantumhealth.com
Sanitas (FL & TN): sanitascredentialing@advantumhealth.com
Sentara: Hannah Stoops – hstoops@advantumhealth.com and Tarah Vanhooser - tvanhooser@advantumhealth.com
Surgery Center of North Florida: Tarah Vanhooser - tvanhooser@advantumhealth.com
Suvida Healthcare: Tarah Vanhooser - tvanhooser@advantumhealth.com
Wood River: Tarah Vanhooser - tvanhooser@advantumhealth.com
Contact Phone: <Insert phone number listed on the MP summary under the Provider's name, for all clients approved to do direct provider outreach.> If not on the MedPass, add info from CAQH (if applicable).
Medpass URL: <insert MP URL>
Request: <Insert all details for what needs to be included in the outreach request.> Please add the full list of items needed and be specific especially when ROI's are needed. Examples: Wet Signature on ROI for Education Verification or Specific ROI for University ABC required.
* For Fresenius Initials and Recreds requesting an attestation (missing or expired), enter this exact wording for the Request. The outreach team should also reach out with this exact wording: Please request provider review and update the application and then re-attest to it.
Description: <Any additional info can be added to this field, if needed>
5. All other fields can be left as is. Click on Create.
6. Once the outreach ticket is created, please add a private production MedPass note and include the link to the ticket, along with what is needed for outreach.
Ticket Workflow and Closing Tickets: See Outreach Workflow (Standard) for the full instructions for performing outreach and the attempts process.
The Outreach processor will assign the ticket to themselves, as the person responsible for doing outreach for that ticket.
NEED ADDITIONAL INFORMATION: If the outreach ticket does not contain all information required to perform outreach, or outreach needs to be placed on hold for any reason, the Outreach processor (Assignee) will update the workflow status drop-down to NEED ADDITIONAL INFORMATION.
The Outreach processor (Assignee) will also tag the outreach requestor (Reporter) in the ticket to request that the information be added to proceed with outreach.
The outreach requestor (Reporter) will then be responsible for adding the missing information to the ticket and then tagging the Outreach processor (Assignee) to notify them that the ticket has been updated.
If the ticket needs to remain in the NEED ADDITIONAL INFORMATION status because we cannot obtain the needed info to proceed with outreach, the outreach requestor (Reporter) will add a note to the ticket and tag the applicable Account Manager (AM) as well as adding a MP note: The following is needed to proceed with outreach: <insert items needed>. Outreach is on hold until that information is received. If required for specific clients, we will need to email Solution Services directly.
Outreach Responses: The Outreach processor (Assignee) will add a note to the outreach ticket and tag the outreach requestor (Reporter) when an outreach response is received from the provider or client. The outreach requestor (Reporter) will receive an email notification with this response.
The outreach requestor (Reporter) will then be responsible for reviewing the outreach response and determining if the ticket can be resolved.
If the outreach request can be resolved, the outreach requestor (Reporter) will add the following note to the ticket and as a MedPass Note: All needed items have been received for this outreach request. Closing ticket as DONE WITHOUT MAX ATTEMPTS MADE. Close the ticket by updating the workflow status drop-down to DONE WITHOUT MAX ATTEMPTS MADE.
If the outreach request cannot be resolved (items still needed), tag the applicable outreach processor by adding the @ symbol and their name and add the following note: The following needed item(s) have NOT been received for this outreach request: <insert items needed>. This ticket must remain open with additional outreach attempts made. This note will also be added as a MedPass Note by the outreach requestor (Reporter). The ticket workflow status will need to remain in the NEED TO CONTACT or AWAITING NEXT CONTACT DATE status.
Outreach Attempts Maxed/Unsuccessful: If the Outreach team has made the (3) required attempts and a response has not been received within 4 business days, the following process will be followed:
The Outreach processor (Assignee) will update the MedPass Status to AM/Client Review, or Under Review (Walmart), if the MedPass is not yet due.
The outreach team will tag the requestor (Reporter) and the applicable Account Manager (AM) in the outreach ticket with the following note (This note will also be added as a MedPass Note by the Outreach processor (Assignee)). If required for specific clients, we will need to email Solution Services directly.
Non-Walmart Clients: The following needed item(s) have NOT been received for this outreach request and outreach attempts have been maxed: <insert items needed>. The MedPass status is being updated from In Process to AM/Client Review until the needed items are received.
Walmart: The following needed item(s) have NOT been received for this outreach request and outreach attempts have been maxed: <insert items needed>. The MedPass status is being updated from In Process to Under Review until the needed items are received.
The Outreach processor (Assignee) will close the outreach ticket as MAX ATTEMPTS MADE.
The requestor (Reporter) will then be responsible to follow the applicable process on MP Release Delays - Process or Order Delays - Process, in order to ensure that the order is closed or the MedPass is released by the due date.
MIT Health: The above steps should be followed for all maxed outreach for MIT Health Providers. We must also tag the AM, Brenda Chihi, directly in the outreach ticket, so MIT Health can take over outreach. This applies to all MIT provider outreach, including outreach for items needed in order to complete a verification, as well as missing application requirements.
Outreach Responses for Documents uploaded to SFTP: If documents are uploaded by the client when responding to outreach requests where we contact the client directly, check the following folders and file paths in SFTP:
Advantum Dual Clients: /users/Advantum/Dual Clients
Baptist Health: /users/Advantum/Dual Clients/Baptist Health
HealthPro Heritage: /users/Advantum/Dual Clients/HPH
Planned Parenthood of Southwest and Central FL: /users/Advantum/Dual Clients/Planned Parenthood of SW and Central FL
San Bernardino County DBH - Access Unit: /users/Advantum/Dual Clients/San Bernardino County-DBH Access Unit
Sentara: /users/Advantum/Dual Clients/Sentara
Surgery Center of North Florida: /users/Advantum/Dual Clients/Surgery Center of North Florida
Other clients that may upload docs from client outreach requests:
Quest Diagnostics: /users/Quest Diagnostics
Client Due Dates (TAT):
Client Due Dates (TAT):
Client Due Dates (TAT): The Standard Due Dates (TAT) is 45 calendar days from the MedPass Submitted Date, unless otherwise stated below. We cannot exceed the listed due date for any clients.
Advantum Clients (all below): 30 Calendar Days
Baptist Health
Functional Pathways
HealthPro Heritage
Keplr Vision
Kidney Care and Transplant Services of N.E. (only Lite MPs)
Planned Parenthood of FL
San Bernardino County DBH - Access Unit
Sanitas (3 sub clients): Sanitas - Florida; Innovista-Texas; Sanitas - Tennessee
Sentara Medical Group
Surgery Center of North Florida
Suvida Healthcare
Wood River Health Services
Costco - 15 Business Days
CVS - 3 Business Days
If CVS uploads the application before 2:00 PM MST, that day is included in the 3 day TAT.
If CVS uploads the application after 2:00 PM MST, that day is NOT included in the 3 day TAT and can start the following day.
CVS Aetna Clinical PMO - 10 Business Days
Fresenius - 30 Business Days
30 Business days applies to MPs due for Initial and Recred only.
60 Calendar days applies to those due for Monitoring/Precred.
MIT Health - 30 Calendar Days
National Center for Safety Initiatives - 30 Calendar Days
Physicians World - 25 Calendar Days (We have 30 calendar days from the date the file was uploaded by the client to SFTP. Adjusted TAT to 25 days on 5/21/25 to ensure we meet the TAT.)
Sentara - 30 Calendar Days
Walgreens / Walgreens Prehire - 3 Business Days
Walmart (Full) - 20 Business Days
Walmart (Lite) - 5 Business Days
Walmart - Pharmacists in Arkansas - 5 Business Days
All Other Clients not listed above - 45 Calendar Days
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