Here are the typical documents we need for Credentialing a Healthcare Provider, so that they can “bill any insurance company”.
If you don’t have these documents, we can get them for you!
- W9
- CAQH – user name and password, Provider ID# and signed attestation.
- If not set up with CAQH, we need all personal information – DOB, SSN, Birthplace, etc.
- Current Medical License
- Copies of all Medical School Diplomas
- Current Certificate of Malpractice Insurance, which should include all of the services provided by Telehealth
- NPI Information (Group/Individual)
- Copy of Boards taken
- Current DEA
- Current CV
- If previously with another practice – old tax ID, practice name/address
Telemedicine: Additional required documents include multiple state licenses.
The provider must be licensed in the state where the patient is located. PECOS certification.
We are located west of Nashville, Tennessee. We can come to you or help you remotely.
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CREDENTIALING SERVICES HCP
Only, TN 37140
615-423-5515