Independence Health Group Inc Credentialing Services

Thank you for your interest in being a member of Independence’s provider networks. All providers who want to join our networks must fill out and return a credentialing application, which is outlined below.

The information gathered throughout the credentialing process is strictly secret and will not be disclosed to third parties. The submission of the credentialing application and the necessary accompanying documentation does not guarantee membership in Independence’s network (s).

Our Specialist will help you get credentialed right away

We will primarily evaluate your educational history, career experience, certificates, and registration to practice in a healthcare sector during the credentialing process. We will track your progress throughout the credentialing test in order to determine your education, training, credentials, and registration to practice in a health care context. We will check all of your paperwork to ensure that you are certified by one of the world’s most prestigious healthcare specialists. As a team, we are committed to long-term development. We will assist you in obtaining the services you require. This is how we show our thanks for our consumers and our commitment to their satisfaction.

Credentialing Criteria

Any professional provider who wishes to join our network must fill out and return a credentialing application kit. You can make this procedure easier by using the online credentialing application provided by the Council for Affordable Quality Healthcare (CAQH): ProView CAQH.

When applying to be credentialed with Independence Blue Cross, applicants should review and adhere to the following credentialing criteria:

A completed, signed, and dated application comprises, but is not limited to, work history for the five years preceding the day the application was signed, including month and year, with a written explanation of gaps more than six months;

• completed education and training (e.g., medical school, residency training, and fellowships);

• statement of chemical dependency or substance abuse;

• loss or limitation of license or felony convictions;

• loss or limitation of hospital privileges or disciplinary action;

• Reasons for any inability to perform the essential functions of the position, with or without accommodation; (credentialing warranty).

• Physicians and other health care practitioners must hold a valid, unrestricted license.

Subject to probation, proctoring requirements, or other disciplinary action, to practice his or her specialty in each state where the practitioner holds a license to practice his or her profession and specialization. When needed by state or federal law/regulation, a copy of the current license(s) and any necessary certificates must be submitted with the application. Therapeutic optometrists must also be licensed as a Therapeutic Pharmaceutical Agent (TPA).

Chiropractors who provide physical therapy must also hold the necessary supplementary licenses in order to provide those services.

Board Certification:

• Primary Care and Specialty Physicians, including Podiatrists, must be board certified in their field of practice. Non-Board Certified applicants who finish an ACGMEAOA recognized residency or fellowship board certification training programme in the same specialty and when member access difficulties are detected may be granted an exception. A practitioner whose board offers a clinical pathway to board certified must either seek certification directly from the board or obtain written confirmation from the board showing that the practitioner has satisfied all of the qualifying requirements for the certification of interest. The plans will not take on the job of the board in examining a practitioner’s qualifications to determine eligibility for a clinical pathway to board certification.

• Physicians must be board certified in the area of practice by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA).

• Podiatrists are required to be certified by the American Board of Podiatric Surgery or the American Board of Podiatric Medicine. The International Board of Certified Lactation Consultants certifies lactation consultants (IBCLC).

Practitioners who were qualified as General Practice specialists were grandfathered into the specialty “General Practice” in June 2012. Practitioners cannot be credentialed or re-credentialed in the “General Practice” specialty (save those who were previously grandfathered) since it is not recognized as a board by the ABMS or the AOA.

• When relevant, Drug Enforcement Agency and Controlled Dangerous Substances certification must be submitted.

• Liability insurance coverage as defined by the state(s) in which the applicant practices is necessary.

• Affiliation with a hospital as needed by state law/regulation.

• The practitioner must give a report documenting his or her malpractice history for the previous five years, beginning with the date of the application’s signature. Professional liability claims that resulted in settlements, arbitrations, or judgements paid by or on behalf of the practitioner are included.

• Applicants must be eligible to participate in any Medicare/Medicaid or government programme at the time of application.

Re-credentialing

CAQH ProView® will be utilized to re-credential, or re-attestation. It is the procedure of registering into CAQH ProView, making changes as needed, and then attesting, or certification, that all of the data is right. Every 120 days, confirmatory testing is needed.

Independence Health Group Inc. Phone Number

Customer Service Staff are available Monday through Friday from 8 a.m. to 6 p.m. 1-800-275-2583.

Independence Health Group Inc. Email Address

Send an email at this address: credinquiries@ibx.com

Independence Health Group Inc. Enrollment Form

You can get every detail of this organization and related to their plans and Forms at given site
https://www.ibx.com/resources/for-providers/tools-and-resources/forms-and-compliance/forms

House of Outsourcing Billing Services

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