In 1997, the California Medical Association developed a comprehensive application to relieve medical service providers of the burden of completing the many forms required by third party payors to verify the completeness of a provider’s qualifications. Unfortunately most insurance companies do not accept this form and require one of their own applications for credentialing purposes. As a Professional Credentialing Services (PCS) client, the physician need only complete the California Physician Participating Application (CPPA) along with associated Addendums A and B Form, one time only. The answers to this comprehensive application are entered into PCS’s database and are afterward always available for quick and accurate retrieval in whatever formats the provider requires.
There are five distinct steps to the submission and retrieval process once an account has been established.
1. Complete the California Physician Provider Application (CPPA):
This is the source of the data, which will populate the PCS database and need only be submitted once. Occasionally, the provider will be asked to provide an original signature for this form. This will occur if a hospital or insurance company will accept this form in lieu of their standard form. PCS will request regular updates from the provider to keep this information accurate and current.
2. Submit all necessary attachments:Copies of key documents (state license, board certification, CV) will be kept on file at PCS, and will be returned to the provider with each requested application. This eliminates the need for the provider to keep these documents readily available. Additionally every critical license, board certificate or CME hours will be scanned and formatted to become a part of the annual physician disaster recovery CD.
3. Verify completeness:
Once the provider signs off on the accuracy of the data in the databases, PCS can complete any insurance or hospital form on the client’s behalf.
4. Insurance company application or hospital reappointment request (s):
All requests for information and/or forms you receive from managed care companies, hospitals, and malpractice companies need to be sent to Professional Credentialing Services so we can assure prompt processing. A correct and accurately completed application along with all applicable documents which are on file will be returned to you for verification and signature.
5. Review, sign and send:
Each application will be returned to you with a cover sheet that outlines what data and signatures are required before submission. You must review the application and sign in the appropriate places and return the documents to PCS for mailing. PCS will then track the application to completion.
*PCS is always available to work with clients to find ways to use provider data for reporting, analysis, and advertisement, whether for the client or third party use.
Contact Professional Credentialing Services at (661) 298-2541 or visit our website http://www.credentialpros.com/
