Kaiser Provider Credentialing Services
Before a clinician is allowed to visit Kaiser Permanente patients, credentialing is a systematic process of collecting and validating required education, training, license, professional references, background, and certifications to provide patient care. This procedure aims to verify that our members receive treatment from providers who are properly trained, licensed, and adhere to quality standards.
Why We?
Kaiser Permanente is a leader in handling the health care industry’s fastest-growing and most complex sectors, including as special populations, complete pharmacy benefits, and other specialty areas. Kaiser promotes innovative technological approaches to improving health while maintaining an emphasis on the important personal interactions required for a healthy, full life. Health plans and other managed care organizations, businesses, and government entities are among Kaiser’s clients. Visit the official website of Kaiser for more details.
Better Care. Better health
Your well-being. This is our cause. We care about your health and that’s why everything at Kaiser Permanente works together for one extremely vital purpose.
Get Credentialed Now
Kaiser Healthcare provides a wide range of mental health management services, combining the best of traditional healthcare delivery methods with cutting-edge, developing solutions.
Requirements
Kaiser Permanente validates needed credentialing information such as
Training& schooling
- Post-graduate education or practice, as well as a practitioner degree [MD/DO/DPM]
- Information on medical or professional education and training
- Fulfillment of a residency plan in the preferred specialty
Authorizing& certification
- Current permit or certification in the country in which the care provider will be practicing
- National Provider Identification [NPI] no
- DEA no./ CDS document
- Medicare certification
Pervious employment details
- 5-year work history
- Description of work conditions, license account and permissions
- [W-9] report
- Hospital staff prerogatives
Insurance
- Active negligence insurance or a government alternatives
- History of misconduct
How to Fill Out and Submit a Credentialing Application
Becoming a Kaiser provider entails becoming an employee rather than a part of a provider panel. Begin by submitting an application through the HMO’s website. You must submit a resume, license details, and a list of past experience. Your application should show relevant experience to the post for which you are seeking. Please save and close your application before submitting it to guarantee that all of your changes are saved. To submit your application, you must first open it,
Get Approved Your Credential
Once we get your completion certificate from CAQH, we will evaluate your application and validate your credentials. We will contact the state licensing board for your license and, among other things, check your educational practice. This primary source evaluation of Kaiser Health Care’s direction is carried out by Aperture. A panel of your peers reviews your request to see whether you meet United Health Care’s credentialing standards. This peer-review procedure could add 20-25 days to the deadline.
Assess Your Status
To ask about the status of your credentials request, send an email to network help. When sending an email to a caregiver, please include their full name, tax ID, and National Provider Identifier (NPI).
Other Criteria and the Interview
You will be called in for at least one interview if your application passes Kaiser’s criteria and there is an open job at a Kaiser location in your region. You may also be asked to submit copies of your driver’s license, school transcripts, and other documents. If you pass the screening, Kaiser will make you an offer that details your employment responsibilities, income, and perks. Because Kaiser recruits providers based on the requirements of the community, we will initiate the verification process once we receive your full application and the needed documents (filled and signed, where applicable). If we have any queries or need additional information, we will contact you right away.
Member’s right
Our members have the right to review and modify information supplied in favor of member credentialing applications. You are not permitted to read peer reviews, peer referencing, or other peer-reviewed protected content. Our member also has the right to be notified of the status of your credentialing or re-credentialing application upon request.
Re-credentialing
Re-credentialing management services are available for providers. This service comprises the following:
Re-attest CAQH profile on Schedule
CAQH should be retested at least once a year. Members may be confident that a CAQH re-attestation deadline will not go ignored.
Update CAQH when Provider demographic changes take place
CAQH should be updated on a regular basis. For providers dealing with similar insurance companies, this is the “cardinal rule.”
Manage contract renewals
Plan contract renewals, which may include pricing negotiations
Keep track of your contracts and make sure they’re up to date
Constantly available customer service
If you’re a provider on an insurance panel, you already know how helpful it is to your practice. Because you accept insurance, you can expand your practice and turn away fewer clients.
However, you must update your agreement with each insurance panel you’re a member of this is known as re-credentialing. This renewal is usually required every two to three years. However, because re-credentialing is a bit of a waiting game, you’ll want to remain on top of it before it catches up with you. Every three years, you must be re-credentialed. We evaluate, among other things, the following: Patient complaint outcomes, Activities aimed at improving quality, Member contentment. Kaiser Permanente may also implement other quality measures. We may also conduct a facility or health record audit at any time in response to patient complaints or other issues.