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Credentialing the BCBSKS Network: CAQH

Linda PrachtLinda Pracht
Credentialing Manager

Blue Cross and Blue Shield of Kansas is pleased to provide information with regard to credentialing. Due to ACA requirements, BCBSKS will be credentialing all providers within its provider network. Join Linda Pracht as she provides more information regarding credentialing and completing the CAQH application

Questions and Answers from Live Webinar

As a Health Department, we have a medical director/consultant, who oversees us. Does This practitioner need to be credentialed?
Yes, if the practitioner is billing any services under his NPI.
Our office just re-credentialed with Medicare. Do we still need to fill out credentialing forms again?
Yes, we require the CAQH application.
In Kansas do you also credential Licensed Masters Level Psychologists and Licensed Clinical Psychotherapists?
We are credentialing the following provider types only at this time.
  1. Physicians
    1. Doctor of Medicine (MD)
    2. Doctor of Osteopathy (DO)
  2. Allied Health Professionals
    1. Advanced Practice Registered Nurse (APRN)
    2. Physician Assistant (PA)
    3. Podiatrist (DPM)
    4. Optometrist (OD)
    5. Chiropractic Medicine (DC)
    6. Dentist (DDS)
    7. Registered Physical Therapist (RPT)
    8. Certified Registered Nurse Anesthetist (CRNA)
  3. Allied Health Professionals (Behavioral Health)
    1. Clinical Psychologist (PhD)(LP)
    2. Licensed Clinical Psychologist (LCP)
    3. Licensed Specialist Clinical Social Worker (LSCSW)
    4. Licensed Clinical Professional Counselor (LCPC)
  4. Institutional Prover Types (Facilities)
    1. Hospitals
    2. Free-Standing Surgical Centers
    3. Home Health Agencies
Are durable medical equipment suppliers required to be credentialed?
No, not at this time.
Will practitioners be notified by the credentialing department when it is time to re-credential?
No, we will only notify the practitioner if the CAQH application is not current or if we need additional information. The only time we notify the practitioner is when they’ve been approved at initial application. At the time of re-credentialing, we retrieve the CAQH application from the website.
Are CRNA’s required to be credentialed?
No, if the practitioner is providing services solely as a CRNA, credentialing is not required.
How are CAQH numbers assigned?
CAQH numbers are assigned by contacting one of the participating health plans. CAQH does not assign individual ID numbers. All health plans that are contracting with CAQH pay a fee to access the CAQH application for each practitioner. The CAQH application is free for the practitioner. If you need to know whether a CAQH number has been assigned, you can contact us and we’ll research it for you.
If I don’t update the CAQH application how long does the information stay active?
Once you’ve been assigned a CAQH ID number and completed the application it will be active until you submit a request to CAQH to have it deleted. You can update the application anytime it is convenient for you. If the application is expired, we will contact you and ask you to update the information. This will eliminate the need for additional paperwork.
Do any hospitals accept the CAQH application?
Yes, we have hospitals in Kansas who are accepting the CAQH application and using their own forms for the privileging component. If the hospital doesn’t have access to the CAQH website the practitioner can print a copy and give it to the hospital.
Am I understanding that all we need to do with a new provider is the CAQH application only? We don’t need to do the paper application anymore?
At this time we still need additional information on all new applicants for directory purposes.

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