WellMed Credentialing Services

We use credentialing to evaluate and choose licensed independent practitioners to provide care to our members. Well-med uses the Council for Affordable Quality Healthcare (CAQH) ProView tool for certification. This private and secure portal reduces the amount of paperwork needed to complete the credentialing process.

What Benefits you will get by working with Us

The following services are provided by House of Outsourcing to our valuables providers on priority basis.

  • To help you through the paperwork, we’ve assembled a team of professionals
  • Savings so you and your team can focus on what you do best: caring for your patients
  • Within 24 hours, you will receive an update on your credentialing progress
  • Let us handle the paperwork so you don’t have to
  • Assistance with panel closure appeals
  • Ameritas credentialing team

How We Help You in Credentialing Process

We will examine your academic background, employment history, credentials, and registration to practise in a healthcare sector during the credentialing step.We will monitor your progress through the credentialing process to analyze your education, training history, credentials, and registration to practice in a health care setting. We will go over all of your paperwork so that you can be certified at one of the greatest healthcare providers in the globe. As a team, we are devoted to long-term growth. We will help you obtain the services you desire. This is how we show our clients how much we appreciate them and strive to provide excellent customer service.

Who Can Be Credentialed?

Well-med credentialing includes, but is not limited to, the following types of health care practitioners:

  • Medical doctors
  • Doctors of osteopathic medicine and more in other categories
  • Chiropractors
  • Medical therapists etc
  • Nurse practitioners who are licensed, certified or registered by the state

Commission on Credentialing

The Credentials Committee (CC) is a peer assessment panel that makes decisions about a practitioner’s participation in a network or Plan. The CC will meet at least every 45 days. The chief medical officer, or a designee designated in consultation with the vice president of Medical and Credentialing Policy, will chair the CC (the Chair of the CC). The CC will be made up of at least two participating practitioners, one of whom practises in the specialty type that most regularly provides services to Company members and falls within the scope of the credentialing programme, with no other responsibility in network management for the Company.

Initial Credentialing

When applying for initial credentialing in one or more of Well-med networks or Plan programmes, each practitioner or HDO must complete a standard application form. It could be a state-mandated form or a standard form developed or approved by Well-med: For practitioners, the Council for Affordable Quality Healthcare (CAQH), a Universal Credentialing Data source, is used. Visit CAQH’s website at www.CAQH.org to learn more. All verifications must be current and validated within 180 calendar days after the CC’s credentialing recommendation, or as otherwise required by applicable accreditation requirements.

Credentialing Criteria

To be eligible for initial participation in Well-med programmes or networks, all health care practitioners must meet the following criteria within the framework of the Well-med Credentialing Program.

  1. Submission of a full application and needed additions that must not include intentional misstatements
  2. Certificate attestation confirmed date within 180 calendar days of the date of submission to the CC for a vote
  3. Primary reference confirmations within adequate timeframes of the date of submission to the CC for a vote, as deemed by appropriate accrediting companies
  4. Sign of potential material omission(s) on form
  5. Current, accurate, free license to exercise in each state in which the practitioner would provide care to marked individuals
  6. Current license action
  7. History of licensing committee action in any state
  8. Current federal ban and no history of federal sanctions (per System for Award Management (SAM), OIG and OPM report nor on NPDB report)
  9. Have a current, valid, unencumbered, unrestricted, and non-probationary license in the state(s) where they offer Well-med member’s services.
  10. A complaint may be made to this demand for applicants whose licensure work was related to substance abuse and who have shown a least two years of successful cooperation in a manner and monitoring plan; if this exemption is granted, the Plan may request specific documentation from the treating physician and program as it deems appropriate.
  11. Have a current, valid, and unrestricted Drug Enforcement Administration (DEA) and Controlled Dangerous Substances (CDS) registration for prescribing controlled substances; they would treat Well-med members if suitable to the work.
  12. Must not be barred or excluded from participating in any of the following programs: Medicare, Medicaid, or the Federal Employees Health Benefits Program (FEHBP).

Re-credentialing

The re-credentialing process includes re-verification and the Identification of differences in the practitioners or HDO’s:

  • Licensure
  • Sanctions
  • Certification
  • Health status
  • The performance data (including, but not limited to, negligence

Experience, hospital right or other actions) that may indicate on the Practitioner’s or HDO’s professional conduct and support

All applicable practitioners and HDOs in the network within the range of Well-med Credentialing Program is expected to be credentialed every three years unless asked by agreement or state laws.

Well-med Credentialing Phone number

Furthermore, any colleague, health care professional, or business partner who has ideas or comments on how to preserve ethical behavior or identify and avoid fraudulent or unlawful behavior can contact the Ethics Office or phone the Helpline (888) 781-9355

Well-med Enrollment Application

You will be directed to apply online with all of your already obtained credentials. Every entity you enter will be examined and verified. It includes several identifying pre-requisite options for marking and verifying your credibility. As a result, they will double-check all of your information and keep you informed of the status of your ongoing procedures and progress.

Well-med Enrollment Email

The below mentioned email address and phone number can also be used to confirm eligibility status, benefits, and common questions websitecontactus@wellmed.net