Brighton Health Plan Solutions Credentialing Process
This file outlines the credentialing process for individual and organizational providers seeking participation in Brighton Health Plan Solutions (BHPS). It includes requirements, instructions for application, and important contact information. Users can reference this document for guidance on credentialing in the BHPS network.
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How do I fill this out?
To fill out the BHPS credentialing application, begin by collecting all required documents and information. Ensure that your CAQH profile is updated and attested if applicable. Submit completed applications as specified using the provided contact information.
How to fill out the Brighton Health Plan Solutions Credentialing Process?
1
Gather all necessary documents and information.
2
Ensure your CAQH profile is updated and attested.
3
Complete the application form accurately.
4
Submit your application to the designated contact.
5
Await notification regarding your credentialing status.
Who needs the Brighton Health Plan Solutions Credentialing Process?
1
Healthcare providers applying for participation in BHPS.
2
Healthcare organizations seeking to credential their group.
3
Administrative staff responsible for credentialing processes.
4
Insurance providers requiring proof of credentialing.
5
New practitioners looking to join a provider network.
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What are the instructions for submitting this form?
To submit this form, please ensure all sections are completed accurately. Email your application along with a W-9 form and all required attachments to recruitmentrequests@magnacare.com for individual providers or customerserviceinquiries@magnacare.com for organizations. If you require further assistance, please contact the provided number or email for guidance.
What are the important dates for this form in 2024 and 2025?
Important dates in 2024 include application deadlines for credentialing decisions. For individual providers due for re-credentialing, ensure all paperwork is submitted six months prior to the deadline. Stay informed about any changes in submission timelines or requirements as specified.
What is the purpose of this form?
The purpose of this form is to facilitate the credentialing of individual and organizational healthcare providers within the Brighton Health Plan Solutions network. This assures that all providers meet the required standards of care and compliance necessary for participation. It serves as a structured guideline to help maintain quality in healthcare services offered to plan members.
Tell me about this form and its components and fields line-by-line.
- 1. Application and Attestation: Section to include application details and sworn statements by providers.
- 2. Current License: Proof of a valid and unencumbered license to practice.
- 3. Malpractice Insurance: Details regarding current malpractice insurance coverage.
- 4. Board Certifications: Information on current board certifications applicable to the provider.
- 5. Contact Information: Information on how to get in touch with the provider.
What happens if I fail to submit this form?
Failure to submit this form may result in your application not being processed, which can hinder your ability to participate in BHPS. It’s essential to ensure all required documents are submitted in a timely manner to avoid any disruption in the credentialing process.
- Application Delay: Incomplete applications may lead to significant delays in the credentialing process.
- Termination Risk: Failure to provide requested information can result in termination from the provider network.
- Loss of Network Access: Unsubmitted applications prevent access to our healthcare networks.
How do I know when to use this form?
- 1. Initial Credentialing: For new applicants seeking to join the BHPS network.
- 2. Re-credentialing: For existing providers due for periodic re-evaluation.
- 3. Updates to Provider Information: Whenever there are changes to practice ownership or structure.
Frequently Asked Question
What is the purpose of this credentialing form?
This form is required for individual and organizational providers to apply for participation in the BHPS network.
Who should fill out this form?
Healthcare providers and organizations seeking to be credentialed with BHPS must complete this form.
How can I edit the PDF?
You can edit the PDF on PrintFriendly by accessing our editing tools available for all users.
What happens after I submit the form?
After submission, the Provider Credentialing Committee will review your application and notify you of their decision.
What information do I need to provide?
You need to provide your application, attestation, current license, and other supporting documents.
How long does the credentialing process take?
Credentialing decisions are typically made within 90 days of receiving a completed application.
Can I track the status of my application?
Yes, you can email the credentialing updates contact for your application status.
Do I need to renew my credentialing?
Yes, individual and organizational providers are re-credentialed every 36 months.
What is my next step after filling the form?
After filling out the form, ensure to submit it to the specified email addresses provided in the document.
How can I ensure my CAQH profile is current?
Regularly log in to your CAQH profile to update and attest the necessary information.
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