Coastal Practice Medical Management provides full service credentialing and privileging functions for our individual physicians and start-up clients. Working alongside the physicians and their staff, we obtain all licensure, degrees and certificates along with the myriad of credentialing documentation required for Hospital and Payer Credentialing. The following services are offered to our clients:
If time and quality verifications are vital to the success of your network efficiency and productivity, you need a cost-effective, secure solution for ensuring the accuracy of your providers' data.
We offer a variety of solutions for handling the many different forms of verification needs. Contact us to determine the right solution for your Credentialing verification needs.
We are a full service Credentialing Verification Organization.
1. Application assembly and mail outs for initial and reappointments
2. Data entry of all applications, This is very time consuming, so have the proper documentation the first time will get you and your staff credentialed faster.
3. All primary source verifications as required by appropriate accrediting bodies, state and federal regulations and facility bylaws (includes verification of all licensure, education/training, certifications, peer recommendations, past and present hospital affiliations, adverse actions, malpractice payments, exclusions)
4. Continuous follow-up and correspondence with practitioners being credentialed to ensure timely completion of files
5. Our turn-around time is 45 days for Initial applications and 30 days for Reappointment applications with all the information from your staff to work from. If we do not have proper information the work can take longer. Our work is completed within a 45 days period.
The insurance can take up 120 days for al physicians to be credentialed within their system.
What credentials do you need to be credentialed?
01. NPI (National Provide Identification) Number & Tax ID Number
02. State License# and all other states that you provide service in (Certificates from the state/states')
This will have your validation dates
03. A CV Resume of Bio of where you went to school, job history,
04. DEA Registration Number
05. Controlled Substance Registration Certificate
06. Insurance Certificate/Copy of updated insurance policy (Certificate of Liability Insurance)
07. A Completed W-9 form
08. All documents will come, to be signed by a standard authorization, Attestation, and Release form.
09. Medicare Number-
10. Medicaid Number
Most importantly need to know, what insurance you are credentialed with, and the insurance you would like to be credentialed with {such as Aetna, Cigna, BCBS-which state, Magellan, Tricare, Ameri-health, Ameri-Choice, etc} Every state has different specialty insurance.
CPMM is no longer credentialing for Medicare-
We can get you the documents for you to complete and send in
