Client Requirements

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

File Import

Account Manager

Robert Simmons

Outreach

N/A

Fees (Passthrough)

Passthrough Fees are approved.

Board Certs

Board Certs: Verified for MedPass Types Licensed and Certified.

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

File Import

Outreach (If Board Certs need ROI)

Provider Outreach is not approved. If a signed ROI is needed to verify a Board Cert, please place outreach on hold and do NOT add for outreach.

Account Manager

Tiffanie Windhorst

Fees (Passthrough)

Passthrough Fees are approved.

Board Certs

As of 9/26/24, we are no longer required to verify Alignment Board Certs, per a Change Control request. 

Board Cert - Not Verified, as of 9/26/2024.

* If a Board Cert order has generated and is pending on the MedPass, follow these steps:

1. Close the order out as Not Found with this note: Board Certifications for Alignment are no longer required to be verified as of 9/26/2024.

2. Move the Board Cert verification on the MedPass to inactive by clicking on Move to Inactive, within the verification details.

Archived Process (the following process is no longer used, as of 9/26/2024):

Board Cert - Verified if provided, NOT required to have a BC. Do not request if missing.

Provider Outreach is not approved for any Alignment providers: If a signed ROI, or any other additional information is needed to verify a Board Cert for an Alignment provider, we will first need to reach out to Jeannette Rodeghiero to request the ROI, or additional information that they have on file from their Advantage verification. Contact Nathaly or Kaylynn and they will reach out to Jeanette. If Jeannette does not have the ROI or other info that is needed to proceed, then we will need to reach out to Solution Services at SolutionServices@verisys.com and Tiffanie Windhorst (the AM) to request the items needed from the client.

For Alignment Board Cert verifications that fall under ABMS that require outreach for a signed release or mailed payments, we can verify using the Advantage ABMS data. Outreach is not approved for any Alignment providers. See Alignment BC Verifications - Advantage ABMS for the full process to access the Advantage ABMS Board Cert data to complete these Board Cert verifications.

For Board Certs with NCC (National Certification Corporation), the NCC ID# is required to verify. If the Alignment Board Cert entry does not include the NCC ID#, or the certification document is not attached, we will need to reach out to Jeannette to request the NCC ID# they have on file from their Advantage verification. Please reach out to either Nathaly or Kaylynn, so they can reach out to Jeanette Rodeghiero to request the IDs. Once the NCC ID# is received, we will then attempt to verify directly with NCC.

Other Requirements

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

Advantum will be completing MP with data obtained from a CAQH application that should be attached containing all application data including completed disclosure questionnaire and attestation form. Advantum will obtain a current ROI when possible and attach to the MedPass.

Recred Frequency

3 years

Account Manager

Robert Simmons

Outreach

Outreach Attempts cannot go to Provider.  All outreach attempts should be directed to the client: tvanhooser@advantumhealth.com and AKrefting@advantumhealth.com  after MP documents have been reviewed for a compliant ROI.

Missing information - Review CACH Documents to see if missing info can be obtained prior to outreach.

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: Education: ECFMG up to $75 is approved. Any other fees are only approved if BC is not present.

* 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 Advantum: tvanhooser@advantumhealth.com and AKrefting@advantumhealth.com

Board Certs

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

* Board Cert is the highest level of Education for all providers.

* Certifacts is approved for ABMS Boards for this client.

* As of 10/25/2023, we will use the re-verification date listed on the ABMS/Certifacts verifications as the expiration date within the Board Cert verification.

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

* Active Board Certs must be verified within (90) days of MedPass Release Date.

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

Attestation - date will be entered by customer via DE. It must be within 120 days of Release Date and a copy of the Attestation and/or the entire CAQH attached documentation should be attached. Customer will then submit.

Expiration Dates MUST be entered in order for the verified dates to pull back for monitoring.

For MP Types: Board Certified Pharmacy Tech Non-Licensed and Board Certified Pharmacy Tech - If a PTCB or NHA Certification is NOT FOUND for this MP Type, we need to return at least one Not Found result (either PTCB or NHA).

If there aren't any Not Found BC results - add a PTCB entry with the following data, in order to return as Not Found. You do not need to add a second entry for NHA.

Specialty: Pharmacy Tech

Accrediting Agency: NCCA

Certifying Organization: Pharmacy Technician Certification Board

(Leave all other fields blank)

Submit MedPass to generate the BC order in EagleGate - click on Submit Application and Submit Without Attestation. Complete the Board Cert order in EagleGate with the applicable verification or Not Found details. 

**If returning as Not Found, make sure that the Not Found result is pulling back to the MedPass and is marked as processed.

Populate the fields on the 'Costco Check for BC' tab for each provider. If a Board Cert is already entered on the MedPass, further searching is not required. If it has a red X (Assess or Not Found) or is listed as Self-reported, enter X in the Additional Notes field on this tab.

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

Initial DE

Update API

Account Manager

Brenda Chihi

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.

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. Can close out as 'Unable to Verify' after (3) attempts are made, but NOT before (2) weeks after the MedPass submitted date.

Please add the Company ID to column F - Provider Unique ID when adding to outreach

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

Verification Attempts Requirements:  requires (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, including ECFMG. Larger fees over $75 require approval to be sent to Account Manager.

Personal Information (Incorrect)

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

Board Certs

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

* Board Cert is the highest level of Education for Physicians only. 

* SPECIAL REQUIREMENT: Profession/Taxonomy of Allopathic & Osteopathic Physicians; Allopathic & Osteopathic Physicians - Internal Medicine - Nephrology; AND Allopathic & Osteopathic Physicians - Pediatrics - Pediatric Nephrology must include Internal Medicine and Nephrology as one of the Board Cert Specialties. Nephrology as the sub-specialty is not acceptable. Training for a completed Fellowship in Nephrology must be done in this scenario.

* Board Cert for Nurse Practitioners or Physician Assistants will NOT be verified. Only verified for Physicians. Fresenius PA's & NP's do NOT have the Board Cert section.

* Active Board Certs must be verified within (90) days of MedPass Release Date.

*Approved to use ABMS Certifacts for verifications

* As of 10/25/2023, we will use the re-verification date listed on the ABMS/Certifacts verifications as the expiration date within the Board Cert verification.

*If our Certifacts account is temporarily unavailable to use and we need to verify directly with the ABIM or ABFM sites, then we will need to use the following processes outlined below for ABIM and ABFM:

*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.

*American Board of Family Medicine (ABFM): Board certification verifications verified through ABFM do not include a full certification date or an expiration date. For the Effective/Certification Date 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.

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

Attestation - Required for ALL MP Types due for Initial and Recred. We should not process any orders, with the exception of the following, or release MedPasses without an Attestation present (as of 12/16/22):

Verifications that can be processed without an Attestation:

* FACIS

* License Verifications

* DEA Verification

* NPDB

* Abuse Registry

* Sex Offender

* OFAC

* County Criminal

* SSA DMF

Must have signed CM Attestation signed within 120 days of Release Date. If Attestation is OLDER than 120 days, place provider on CS Outreach. MedPass should be placed on HOLD until Attestation is within 120 days, even if outreach attempts are maxed.

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

File Import

Account Manager

Brenda Chihi

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

Board Certs: MP Type Pharmacy Service Providers - Pharmacy Technician

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

One time data upload. Future data will be entered by MIT and supplemented  by Provider after they are invited into the system. Providers are required to complete their MedPass application and Attest within CheckMedic.

Recred Frequency

3 years

Account Manager

Given the population size, they will work with Customer Care. No one has been assigned specifically. 

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) 

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

Fees (Passthrough)

Passthrough Fees are approved.

ECFMG passthrough fee is approved.

Personal Information (Incorrect)

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

Board Certs

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

* Certifacts is approved for ABMS Boards for this client.

Active Board Certs must be verified within (90) 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 120 days of Release Date. (Not required for MP Type: Pre Cred)

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

File Import

Account Manager

Brenda Chihi

Outreach

NW Paid Board Cert Requests: If there is a fee to verify a Board Cert, or if we need to request a Board Cert ID, add the info to this doc for columns A-H for client approval.

Fees (Passthrough)

All Board Cert passthrough fees require client approval for Northwestern.

NW Paid Board Cert Requests: If there is a fee to verify a Board Cert, or if we need to request a Board Cert ID, add the info to this doc for columns A-H for client approval. This includes the orders for BOC (Board of Certification) - $30 Fee Required.

• If the AM marks it as Yes under Approved Y/N (column L), the order can be processed after the fee is paid and logged on Verification Ops Passthrough Fee Tracking

• If the AM marks it as No under Approved Y/N (column L), the order should be closed as Not Found with the following note: *Unable to verify as the Board charges a fee to verify, which is not approved by the client.

• The following Board Certs do NOT need to be added to the NW Paid Board Cert Requests, as we have pre-approval from the client for fee payment and processing:

  • • ASCP BOC (American Society for Clinical Pathology): All $20 fees are pre-approved to proceed with payment.

Board Certs

Board Certs Verified if supplied for MP Type: Licensed

Board Certs with ENA (Emergency Nurses Association): 

• A signed ROI is required to verify board certs with ENA (Emergency Nurses Association).

• Northwestern will create their own ROI form to have their providers sign and return to us (digital signature is okay).

• We do not need to do outreach or contact the AM for signed ROI's to verify Board Certs with ENA. 

• If the client's signed ROI is not received when the MedPass due date is approaching (45 days after MP submission), the Board Cert order should be closed as Not Found with the following clipping: The signed Release of Information required to complete the Board Cert verification with ENA (Emergency Nurses Association) has not been received from Northwestern. The Board Cert. verification order is being closed as Not Found. If/when the signed Release of Information is received, we will proceed with the Board Cert. verification with ENA. 

State Licenses Supplied as a Board Cert

If a State License is supplied as a Board Cert, such as an Illinois State CNA license or Illinois State Radiologic Technologist license, with the board name listed as Illinois Department of Financial and Professional Regulations or Illinois Emergency Management Agency, the order should be completed with a Verified Status of 'Not Regulated'. This will map back to the MedPass as Unable to Verify.

The following clipping should be added to the Notes: 

*The submitted board, Illinois Department of Financial and Professional Regulations, is not a board certifying agency. The information provided is for the provider's IL's state (Insert Specialty) license.

OR

*The submitted board, Illinois Emergency Management Agency, is not a board certifying agency. The information provided is for the provider's IL's state (Insert Specialty) license.

-----------------------

Completed by (First name initial Last name) 

Board Certs with CPR (AHA): 

• If a CPR certification for AHA has been entered under the MedPass Board Certifications section, the EagleGate order should be closed out with an Eligible Status of Not Certified and Verified Status of Not Found. All CPR certifications are verified for Northwestern within the Certifications section of the MedPass.

• The following clipping should be added to the order notes:  Unable to verify with the Authority provided. Per client, the submitted board, American Heart Association, is specifically to be completed through CPR Certifications Process Queue for Northwestern client. Verification for provider's AHA eCard CPR Certifications are available for review under the MedPass Certifications section.

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

DE completed by us using ARMS applications and documents that are uploaded by client to SFTP.

Recred Frequency

3 years

Account Manager

Rob Simmons

Outreach

Outreach Attempts cannot go to Provider.  All outreach attempts should be directed to the client: tvanhooser@advantumhealth.com and AKrefting@advantumhealth.com after MP documents have been reviewed for a compliant ROI (if ROI is needed for a verification)

Missing information - Review CACH Documents to see if missing info can be obtained prior to outreach.

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

Verification Attempts Requirements: 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 for outreach.  

All outreach attempts should be directed to the client: tvanhooser@advantumhealth.com and AKrefting@advantumhealth.com 

Board Certs

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

* Board Cert is the highest level of Education for all providers.

* Certifacts is approved for ABMS Boards for this client.

* As of 10/25/2023, we will use the re-verification date listed on the ABMS/Certifacts verifications as the expiration date within the Board Cert verification.

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

* Active Board Certs must be verified within (90) 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 ARMS application. Attestations must be signed within 120 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

3 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 for Initial and Recred. Board Cert Requirements are set up by MP Professions:

* Allopathic & Osteopathic Physicians - Physical Medicine & Rehabilitation = American Board of Physical Medicine and Rehabilitation, Inc.

* Allopathic & Osteopathic Physicians - Internal Medicine = American Board of Internal Medicine, Inc.

* Allopathic & Osteopathic Physicians - Family Medicine = American Board of Family Medicine, Inc

* Allopathic & Osteopathic Physicians - Emergency Medicine =  American Board of Emergency Medicine, Inc

* Allopathic & Osteopathic Physicians - Preventive Medicine = American Board of Preventive Medicine, Inc.

* Allopathic & Osteopathic Physicians - Pathology = American Board of Pathology, Inc.

* Allopathic & Osteopathic Physicians - Radiology = American Board of Radiology, Inc

* Allopathic & Osteopathic Physicians - Psychiatry & Neurology = American Board of Psychiatry and Neurology, Inc.

Active Board Certs must be verified within (90) 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 120 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

3 years

Account Manager

Jocelyne Wood

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 for MP Type: Medical (Not required to have, but must be verified if provided.

Active Board Certs must be verified within (90) 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's under MP Type (Medical) on MedPass. Must have signed CM Attestation signed within 120 days of Release Date.

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

Advantum will be completing MP with data obtained from a CAQH application that should be attached containing all application data including completed disclosure questionnaire and attestation form. Advantum will obtain a current ROI when possible and attach to the MedPass.

Recred Frequency

3 years

Account Manager

Rob Simmons

Outreach

Outreach Attempts cannot go to Provider.  All outreach attempts should be directed to the client: tvanhooser@advantumhealth.com and AKrefting@advantumhealth.com after MP documents have been reviewed for a compliant ROI.

Missing information - Review CACH Documents to see if missing info can be obtained prior to outreach.

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: Education: ECFMG up to $75 is approved. Any other fees are only approved if BC is not present.

* 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 client: tvanhooser@advantumhealth.com and AKrefting@advantumhealth.com  

Board Certs

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

* Board Cert is the highest level of Education for all providers.

* Certifacts is approved for ABMS Boards for this client.

* As of 10/25/2023, we will use the re-verification date listed on the ABMS/Certifacts verifications as the expiration date within the Board Cert verification.

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

* Active Board Certs must be verified within (90) days of MedPass Release Date.

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

Attestation - date will be entered by customer via DE. It must be within 120 days of Release Date and a copy of the Attestation and/or the entire CAQH attached documentation should be attached. Customer will then submit.

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

We will complete DE on the following 14 providers: 

Brenton Fulks

Christina Carlton

Dena McAtee

George Bahri

Gregory Bailey

Harold Locay

Heather Miller

Jonathan Pabalate

K. Lane Folsom

Michael B. Hays

R. Lance Tabb

Richard Sadove, MD

William Jones

Zoltan Bereczki

After these 14 MedPasses, then Advantum will be completing MP with data obtained from a CAQH application that should be attached containing all application data including completed disclosure questionnaire and attestation form. Advantum will obtain a current ROI when possible and attach to the MedPass.

Recred Frequency

3 years

Account Manager

Rob Simmons

Outreach

Outreach Attempts cannot go to Provider.  All outreach attempts should be directed to Advantum: tvanhooser@advantumhealth.com and AKrefting@advantumhealth.com after MP documents have been reviewed for a compliant ROI.

Missing information - Review CACH Documents to see if missing info can be obtained prior to outreach.

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: Education: ECFMG up to $75 is approved. Any other fees are only approved if BC is not present.

* 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 Advantum: tvanhooser@advantumhealth.com and AKrefting@advantumhealth.com

Board Certs

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

* Board Cert is the highest level of Education for all providers.

* Certifacts is approved for ABMS Boards for this client.

* As of 10/25/2023, we will use the re-verification date listed on the ABMS/Certifacts verifications as the expiration date within the Board Cert verification.

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

* Active Board Certs must be verified within (90) days of MedPass Release Date.

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

Attestation - date will be entered by customer via DE. It must be within 120 days of Release Date and a copy of the Attestation and/or the entire CAQH attached documentation should be attached. Customer will then submit.

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

Robert Simmons

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 (Not required to have, but must be verified if provided).

Active Board Certs must be verified within (90) 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 120 days of Release Date.

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

File import

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.

Fees (Passthrough)

Passthrough Fees are approved.

Board Certs

Board Certifications are required ONLY for MP Type of Certified Pharmacy Tech

* Certified Pharmacy Techs: We MUST search PTCB and NHA, add the BC to the MedPass and submit to generate the Board Cert orders, following the WMT BC Add Process. If a PTCB or NHA Certification is NOT FOUND for this MP Type, we need to return at least one Not Found result (either PTCB or NHA).

* 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.

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

File import

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.

Fees (Passthrough)

Passthrough Fees are approved.

Board Certs

Board Certifications are required to be added and verified for an American Registry of Radiologic Technologists Certification.

* 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.