Embedded Files
Processing Tools
Processing Tools
When working Board Certifications, keep the following tools open:
Eaglegate - Internal application for completing verification orders for multiple products including Board Certifications (BC)
CheckMedic - Platform for credentialing and verification of a provider profile (AKA MedPass)
Board Certification Processing Rules - Google site set up for operations guides and training for BC
Google sheets specific to the type of BC (queue orders vs reverification orders)
PiiDat - Internal application acting as an intermediary to search public records
General Instructions
General Instructions
Use the SSN from the order to view the MedPass (MP) in CheckMedic. Make sure the MP is active. If inactive, please reach out to a team lead to have the order moved to inactive verifications. Once it is moved you may complete it as an inactive verification using the clipping listed below.
Search the Board Name from the order on the Board Sites Page of the Board Certification Processing Site
Notice customer (from the MP/order) and board rules. Read through the rules thoroughly. Use the BC verification site link from the rules to search
*Costco Pharmacy Tech BC's: must search PTCB and NHA before returning as Not Found. If not found on provided board, search other Board and return what is located. Notify a Lead in this situation.
Search by all provided names and additional names on PiiDat. If possible, contact the Board to verify.
No results - Exhaust all search options before completing order as Not Found (e.g. search PiiDat or the MP for additional info)
If Board Cert is located, follow the instructions for Certified, Not Certified, or Eligible.
For all Full Credentialing MP's that need to be NCQA compliant, remember that the date listed on the Board Cert verification letter/PDF will need to be within 90 days of the MP release date. If this date listed on the PDF is older than 90 days, we need to redo the verification to obtain a Board Cert verification letter that is within 90 days, in order to be NCQA compliant. This includes BC's that require a fee, those will need to be paid for again. For all Board Certs that require a fee, follow the process located on Fee Process.
Attach PDF of the verification or email from the Board.
Always attach a PDF unless you verified by phone, certain not found situations, and incorrect submissions do not require a PDF
PDF needs to be complete/easily read. Always use the "print" or "download" option to ensure the format is correct.
If you contacted the board via email for any situation, please attach a PDF of the email.
When saving the PDF, keep the file name as short as possible. The PDF file name cannot have too many characters, as well as any special characters, or it can cause issues with the PDF download. Make sure to download the PDF attached to the EagleGate order to ensure that the download will work.
Add Completed by <FIRST INITIAL LAST NAME> to end of notes.
Select applicable Verified Status and Complete.
*Don't include PII in the notes or the PDF.
Filling out Eaglegate Order Fields
Filling out Eaglegate Order Fields
First, Middle, Last Names: paste from verification
Specialty: paste from verification
Board Name: copy and paste the FULL Board Name from the Board Sites page header. (ALWAYS USE FULL NAME, NOT ACRONYM)
Eligible Status: ACTIVE select Certified or Lifetime (if listed as Lifetime on verification), INACTIVE or NOT CERTIFIED select 'Not Certified', ELIGIBLE select 'Eligible' (listed as Eligible on verification)
Accrediting Agency: paste from Board Sites tab listed under Acronym or Accrediting Agency (ALWAYS USE ACRONYM, NOT FULL NAME)
Board Cert Number: only populate if listed on verification
Effective Date: only populate if FULL date (MM/DD/YYYY) is listed on verification
Re-certification Date: only populate if FULL date (MM/DD/YYYY) is listed on verification
Expiration Date: only populate if FULL date (MM/DD/YYYY) is listed on verification
*Check Board Sites Rules there are boards where we utilize specific dates based on the customer.
Certification Date: same as Effective Date if FULL date is provided
Authority Source: copy and paste the FULL Board Name from the Board Sites page header. (ALWAYS USE FULL NAME, NOT ACRONYM) (MUST BE EXACT WORDING TO OVERRIDE TO MEDPASS)
ABMS/Certifacts Verifications - Process for Fields and Dates for EagleGate Orders
ABMS/Certifacts Verifications - Process for Fields and Dates for EagleGate Orders
First, Middle, Last Names: paste from verification
Specialty: paste from verification
Board Name: copy and paste the FULL Board Name from the Board Sites page header. (ALWAYS USE FULL NAME, NOT ACRONYM)
Eligible Status: ACTIVE select Certified or Lifetime (if listed as Lifetime on verification), INACTIVE or NOT CERTIFIED select 'Not Certified', ELIGIBLE select 'Eligible' (listed as Eligible on verification)
Accrediting Agency: paste from Board Sites tab listed under Acronym or Accrediting Agency. (ALWAYS USE ACRONYM, NOT FULL NAME)
Board Cert Number: If the number was provided within the order, copy/paste that to the middle field. This only applies to Certifacts orders since we confirmed with them by phone that they do not list the Board Cert number on the verifications.
Effective Date: only populate if FULL date (MM/DD/YYYY) is listed on verification. The OLDEST Start Date **that does not have any gaps between the associated End Date to the following Start Date should be used.
Re-certification Date: only populate if FULL date (MM/DD/YYYY) is listed on verification. The most recent **Certification Start Date should be used.
**The issue date will be overwritten on the MedPass Summary with the re-certification date, if it is more recent than original certification date. This applies to BCs with MOC only.
Expiration Date: only populate if FULL date (MM/DD/YYYY) is listed on verification. **NOTE: For Advantum, BCBS of VT & Fresenius, we need to use the re-verification date listed on the ABMS/Certifacts verifications as the expiration date.
Certification Date: same as Effective Date if FULL date is provided. The OLDEST Start Date should be used that does not have any gaps between the associated End Date to the following Start Date.
Authority Source: copy and paste the FULL Board Name from the Board Sites page header. (ALWAYS USE FULL NAME, NOT ACRONYM) (MUST BE EXACT WORDING TO OVERRIDE TO MEDPASS)
The following are ABMS Boards. Certifacts is approved to use for these boards for approved Clients (Advantum, CVS/Aetna, Fresenius and MIT Health - updated list 11/21/2024):
The following are ABMS Boards. Certifacts is approved to use for these boards for approved Clients (Advantum, CVS/Aetna, Fresenius and MIT Health - updated list 11/21/2024):
American Board of Allergy and Immunology
American Board of Anesthesiology
American Board of Colon and Rectal Surgery
American Board of Dermatology
American Board of Emergency Medicine
American Board of Family Medicine
American Board of Internal Medicine
American Board of Medical Genetics and Genomics
American Board of Neurological Surgery
American Board of Nuclear Medicine
American Board of Obstetrics and Gynecology
American Board of Ophthalmology
American Board of Orthopaedic Surgery
American Board of Otolaryngology
American Board of Pathology
American Board of Pediatrics
American Board of Physical Medicine and Rehabilitation
American Board of Plastic Surgery
American Board of Preventive Medicine
American Board of Psychiatry and Neurology
American Board of Radiology
American Board of Surgery
American Board of Thoracic Surgery
American Board of Urology
Certified, Active
Certified, Active
1. Copy/paste verification details into Notes.
2. Save and upload a PDF of verification (use printer friendly version if available). PDF needs to be complete/easily read. Always use the "print" or "download" option to ensure the format is correct. When saving the PDF, keep the file name as short as possible. The PDF file name cannot have too many characters, as well as any special characters, or it can cause issues with the PDF download. Make sure to download the PDF attached to the EagleGate order to ensure that the download will work.
3. Copy/paste from verification for all required fields (see FIELDS above).
4. Select the Eligible status 'Certified'.
5. Select Verified Status 'Active'.
6. Add Completed by <FIRST INITIAL LAST NAME> to end of notes.
7. Complete Order.
Not Certified, Inactive
Not Certified, Inactive
Provider was certified but is now Inactive (Expired):
Provider was certified but is now Inactive (Expired):
1. Copy/paste verification details into Notes.
2. Save and upload a PDF of verification (use printer friendly version if available). PDF needs to be complete/easily read. Always use the "print" or "download" option to ensure the format is correct. When saving the PDF, keep the file name as short as possible. The PDF file name cannot have too many characters, as well as any special characters, or it can cause issues with the PDF download. Make sure to download the PDF attached to the EagleGate order to ensure that the download will work.
3. Copy/paste from verification for all required fields (see FIELDS above).
4. Select the Eligible status 'Not Certified'.
5. Select Verified Status 'Inactive'.
6. Add Completed by <FIRST INITIAL LAST NAME> to end of notes.
7. Complete Order.
Eligible
Eligible
1. Copy/paste verification details into Notes.
2. Save and upload a PDF of verification (use printer friendly version if available). PDF needs to be complete/easily read. Always use the "print" or "download" option to ensure the format is correct. When saving the PDF, keep the file name as short as possible. The PDF file name cannot have too many characters, as well as any special characters, or it can cause issues with the PDF download. Make sure to download the PDF attached to the EagleGate order to ensure that the download will work.
3. Copy/paste from verification for all required fields (see FIELDS above).
4. Select the Eligible status 'Eligible'.
5. Select Verified Status 'Not Found'.
6. Add Completed by <FIRST INITIAL LAST NAME> to end of notes.
7. Complete Order.
Not Certified, Not Found
Not Certified, Not Found
Provider was NEVER certified or Incorrect Board Name was submitted:
Provider was NEVER certified or Incorrect Board Name was submitted:
Not Found Status: After all efforts were exhausted and the board certification is still not found or the board does not regulate the board certification type
Eligible status: Not Certified
Verified status: Not Found
Before returning an order as Not Found:
Search the MedPass and Piidat for alternate names or additional info to help locate the board certification
Try different variations of the last names when searching the board
Check to see if there are extra spaces or characters in the search
Make sure to follow the correct search format specific to the verification site
1. Copy/paste from the email response from the Board stating they were never certified, use the calling clipping, or copy/paste the response from the online search showing certification was not found. Incorrect Board Name submitted - a search of other similar certifying is only required by specific customers.
2. Save and upload a PDF of the email response from the Board stating they were never certified. No PDF required if you called or searched online and certification was not found. When saving the PDF, keep the file name as short as possible. The PDF file name cannot have too many characters, as well as any special characters, or it can cause issues with the PDF download. Make sure to download the PDF attached to the EagleGate order to ensure that the download will work.
3. Populate all required fields from data listed on left side.
Clipping:
Clipping:
Using Online Search
Using Online Search
(Board Name):
*Unable to locate a record of the provider searching the (Insert name of board) online verification tool.
----------------------------
Completed by [FIRST INITIAL LAST NAME]
Emailed Board
Emailed Board
*Received an email from (Insert name of board specialty) stating they are unable to locate a record of the provider in their system.
----------------------------
Completed by [FIRST INITIAL LAST NAME]
Not Found verified via Phone
Not Found verified via Phone
*Contacted (Insert name of board specialty) at (Insert telephone number) and verified they are unable to locate a record of the provider by name, SSN or DOB in their system.
----------------------------
Completed by [FIRST INITIAL LAST NAME]
4. Select Verified Status 'Not Certified'.
5. Select Verified Status 'Not Found'.
7. Complete Order.
Not Certified in the Provided Specialty
Not Certified in the Provided Specialty
The specialty submitted within the order is not found, but at least one of the other specialties the board certifies can be found as certified:
The specialty submitted within the order is not found, but at least one of the other specialties the board certifies can be found as certified:
Not Found Status: After all efforts were exhausted and the board certification for the submitted specialty is still not found or the board does not regulate that specialty.
Eligible status: Not Certified
Verified status: Not Found
1. The verification for the certified specialty should NOT be listed in the notes. Add the following clipping for the not found specialty.
2. Save and upload a PDF of the verification of the specialty that is certified with the Board. When saving the PDF, keep the file name as short as possible. The PDF file name cannot have too many characters, as well as any special characters, or it can cause issues with the PDF download. Make sure to download the PDF attached to the EagleGate order to ensure that the download will work.
3. Populate all required fields from data listed on left side.
Clipping:
Clipping:
Using Online Search
Using Online Search
(Board Name):
*Unable to locate a record of the provider's specialty in (Insert name of board specialty that is not found) searching the (Insert name of board) online verification tool.
----------------------------
Completed by [FIRST INITIAL LAST NAME]
Emailed Board
Emailed Board
*Received an email from (Insert name of board) stating they are unable to locate a record of the provider's specialty in (Insert name of board specialty that is not found).
----------------------------
Completed by [FIRST INITIAL LAST NAME]
Not Found verified via Phone
Not Found verified via Phone
*Contacted (Insert name of board) at (Insert telephone number) and verified they are unable to locate a record of the provider's specialty in (Insert name of board specialty that is not found).
----------------------------
Completed by [FIRST INITIAL LAST NAME]
4. Select Verified Status 'Not Certified'.
5. Select Verified Status 'Not Found'.
7. Complete Order.
Inactive Medpass/Inactive Order
Inactive Medpass/Inactive Order
Please check to see if the order you are on is listed under Inactive Verification's. If so, please send to follow up and DO NOT COMPLETE
Please Check EACH medpass for BCs, if the Medpass is Inactive, please reach out to a team lead to have the order moved to inactive verifications. Once it is moved you may complete it as an inactive verification using the clipping listed below.
Clipping:
*Verification Inactive on Medpass
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Completed by [FIRST INITIAL LAST NAME]
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