When considering provider enrollment and credentialing services with pie Health, rest assured that our onboarding process is designed for ease and efficiency, entirely online. Here's what you can expect:
Onboarding Made Easy
Upon partnering with pie Health, you'll receive access to our user-friendly web portal via a secure link. The onboarding process is straightforward and guided, following a wizard-style interface. You'll be able to enter essential data and upload required documents with ease.
Handling Situations Without All Documents
We understand that obtaining all necessary documents can sometimes be a challenge. Here's how we can assist in such situations:
Practice and Provider Data: If you're missing certain details or documents during the initial onboarding, don't worry—you can still get started. We recommend providing as much information as you can, and our team will work with you to ensure a smooth process.
Bulk Import Option: For added convenience, we offer a bulk import option for an additional fee. This feature allows you to streamline data entry for multiple providers and locations, even if you don't have all the required documents readily available.
Practice Preparation
This section serves as a comprehensive guide to the document requirements for healthcare practices undergoing insurance credentialing. It begins by outlining the high-level categories of documents essential for the process. Subsequently, a detailed list, meticulously organized by category, follows to ensure clarity and ease in gathering the necessary documentation. These documents are vital for a seamless and successful credentialing experience, helping practices establish strong relationships with payers and streamline their operations.
Gather Essential Information: Collect key practice details, including legal business name, tax identification number (TIN), National Provider Identifier (NPI), and contact information. Ensuring this information is accurate and up-to-date is crucial.
Insurance Coverage Information: Prepare a list of current malpractice insurance policies and details, including policy numbers and effective dates.
Provider Information: Compile comprehensive data on all providers in your practice, including their full names, NPIs, credentials, and any relevant licensing details.
Practice Licenses: Ensure that all practice licenses, permits, and certifications are current and accessible.
CAQH ProView: If your providers are not already registered with CAQH (Council for Affordable Quality Healthcare), consider initiating the registration process. We can assist with this if needed.
Practice Document Checklist
Practice Business Information
Legal Business Name
Tax Identification Number (TIN)
National Provider Identifier (NPI)
State Business License
Certificate of Incorporation or Organization
Business Address and Contact Information
Group NPI (if applicable)
Ownership and Control Information
Names and Titles of Practice Owners
Ownership Percentages
Board of Directors/Partnership Agreements
Practice Provider Information
Full Names and Credentials of All Providers
National Provider Identifiers (NPIs)
Provider License Numbers and Expiration Dates
Curriculum Vitae (CV) for Each Provider
Provider Attestation Forms for Each Provider
Insurance Coverage Information
Copies of Current Malpractice Insurance Policies
Policy Numbers and Effective Dates
Insurance Certificate (if available)
Practice Licenses and Permits
Copies of State Medical Licenses
Copies of State Controlled Substance Licenses (if applicable)
Copies of Medicare/Medicaid Certificates (if applicable)
CAQH ProView
CAQH Provider IDs for All Providers
CAQH Username and Password (if registered)
Practice Specialty Information
Provider Specialty Codes (e.g., Taxonomy Codes)
Board Certifications (if applicable)
Billing and Claims Information
National Provider Identifier (NPI) Enumerator Letter
Electronic Funds Transfer (EFT) Authorization Forms
W-9 Form for Tax Reporting
Voided Check for Direct Deposit
Provider Preparation
In this section, we navigate the essential document requirements for individual healthcare providers during the insurance credentialing process. We begin by outlining the overarching categories of documents crucial for this journey. Following this, you'll find an in-depth list, thoughtfully categorized, to simplify the document-gathering process. These documents play a pivotal role in the provider's credentialing journey, facilitating the establishment of robust relationships with payers and the seamless operation of their practice.
Credentialing Documentation: Providers should have copies of their medical licenses, DEA certificates (if applicable), board certifications, and any other relevant credentials.
Professional Liability Insurance: Maintain up-to-date records of your malpractice insurance, including policy numbers and effective dates.
Work History: Prepare a comprehensive work history, including previous practice locations, job positions, and dates of employment.
Provider Attestation Forms: Be prepared to complete and sign provider attestation forms for each contracted payor.
Provider Document Checklist
Provider Credentialing Information
Full Legal Name
National Provider Identifier (NPI)
Social Security Number (SSN)
Date of Birth
Provider License Number and Expiration Date
Provider Attestation Form
State Licensing and Certifications
Copies of State Medical License(s)
Copies of State Controlled Substance License (if applicable)
Board Certifications (if applicable)
Professional Liability Insurance Certificate
Education and Training
Copies of Diplomas and Degrees
Residency and Fellowship Certificates (if applicable)
Proof of Continuing Medical Education (CME) Credits (if applicable)
Provider CV/Resume
A current Curriculum Vitae or Resume detailing education, training, experience, and professional affiliations
DEA Registration
Drug Enforcement Administration (DEA) Registration Certificate (if applicable)
CAQH ProView
CAQH Provider ID (if registered)
Professional References
Contact information for professional references (if requested by payers)
Insurance Information
Copies of Malpractice Insurance Policy
Insurance Policy Number and Effective Dates
Billing and Claims Information
National Provider Identifier (NPI) Enumerator Letter
Electronic Funds Transfer (EFT) Authorization Forms
W-9 Form for Tax Reporting
Voided Check for Direct Deposit
Additional Preparations (managed by pie Health)
Certain preparations are managed by pie Health to minimize any burden on your end:
Provider Enrollment Application: pie Health will take care of completing and submitting provider enrollment applications to payors on your behalf. You won't need to handle this directly.
Provider Contracts: We will review and negotiate contracts with payors, ensuring favorable terms for your practice.
Fee Schedules: Our team will engage with payors to establish fee schedules that align with your financial objectives.
Timely Follow-Up: pie Health will proactively manage any requests from payors for additional information or clarifications, ensuring a smooth progression through the enrollment process.
Dedicated Account Services Team
We understand that questions may arise during the onboarding process. That's why pie Health provides a dedicated Account Services team that is readily available to assist you. Our team is just a message or call away, with support available through chat, email, phone, and web conference when appropriate. You can count on us to provide the guidance and answers you need, ensuring a seamless provider enrollment and credentialing experience.
At pie Health, we're committed to providing a seamless and efficient experience. Our team will communicate with you at every step, eliminating any uncertainty and simplifying the provider enrollment and credentialing journey. For any questions or assistance, feel free to contact us.
DISCLAIMER: Please note that the specific documents required may vary depending on the payers and state regulations. It's essential to verify the exact document requirements with each insurance company during the credentialing process.