Providers List

Hover over the ConCred icon on the top left corner to access your menu and click on the providers menu to access your list of all providers.

Filters

On the providers list page, by default you will see a list of all the providers who you have access to (based on the office you have access to. Refer Admin user manual for the types of access levels).

You can filter out the list to see providers for any specific type of alerts.

You can also filter providers by office or by title

Through the following filter you can see a list of providers assigned to you vs alerts assigned to the providers to some other team members vs all the providers in the system who you have access to.

You can click on the ‘alert’ icon to see a quick list of all the alerts withing provider’s profile.

Example:

Sorting

Clicking on the sorting icon in the column title will sort the corresponding column.

By default, the list is sorted by provider’s last name.

Selection of Provider

Clicking on the provider’s name will take you to the provider ‘Overview’ page.

Add a new Provider

Use the button on the top right corner of this page to create a brand-new provider.

You have to fill at least the mandatory fields on the ‘Provider Basic Info’ page to create a new provider.

Once the ‘Provider Basic Info’ is filled, your other menu on the page will be unlocked.

Provider Portal Account Creation and Access

After addition of the ‘Provider Basic Info’, the next step is to add ‘Employment Info’ of the provider. Provider Portal account will be created for the provider when at least one service location is added under ‘Employment Info’. Providers will get an email invite to access their provider portal account.

Provider overview

This page summarizes all the alerts and activities within the provider's account.

Provider Info Tile

This tile reflects the profile picture, name of the provider, their designation and their primary service location.

Service Location(s)

This tile will show a count of service locations where the provider is providing services. Clicking on this tile will take you to ‘Employment Info’ menu from the left panel where you can see a list of all their service locations and roles at each location.

Pending Requirements

This tile shows you a status of any pending requirements for any current or upcoming Enrollments for the provider.

Clicking on this tile will take you to ‘Enrollment Req’ menu from the left panel where you can see a list of all compliance items needed by the organization or by the payors for the required Enrollments.

If there are no pending requirements then you will see a check mark showing you that the provider has submitted all required compliance items.

Note:

If you see the pending requirements alert but on ‘Enrollment Req’ page you don’t see any pending items then be sure to check the compliance requirement menu.

Enrollment Request

Ideally a provider should be Enrolled with all the payers at their service location so that they can work on any case at any time however considering the tedious process of Enrollment and limited resources at credentialing department, you can choose to enroll providers only under specific payers. In this case generally (operations) manager/credentialing team is required to submit specific Enrollment requests for the providers.

Click on the ‘Add Enrollment Request(s)’ button to navigate to the Enrollments page where you can add request to the queue.

Refer section for process to request new Enrollment.

Enrollments

This section will show a list of all the Pending, In-Progress or Completed Enrollments.

If no Enrollments are requested for any provider, then you will see this message-

Clicking on the payor name will take you to the Enrollment Details page where you can see statuses along with action items (if any).

Alerts

This section will highlight all the alerts which require your attention. These alerts will go away when the provider takes the required action.

Example:

Here are the types of alerts you will see, and how they will be removed-

Alert: Re-enrollment due in less than 60 days

Relevant Page: Enrollment

Reason: This alert comes up if you have added a renewal date in the enrollment section and it is reaching in less than 60 days. This alert will be automatically removed if a new future approval date is added or if it is marked as ‘not being added’ or if enrollment crosses expiry date. After the expiry date the alert moves to the “Enrollment Expired” category.

Alert: Enrollment expired

Relevant Page: Enrollment

Reason: This alert comes up if you have added a renewal date in the enrollment section and it has passed the renewal date. This alert will be automatically removed if a new future approval date is added or if it is marked as ‘not being added’.

Alert: Pending information from provider

Relevant Pages: Enrollment Req, Compliance Req

Reason: Provider has missing information in Enrollment Req or Compliance Req tabs. Once the provider adds/uploads all the missing information or this item is marked as ‘Not being added’ then this alert will be removed automatically.

Alert: CAQH ID is unavailable

Relevant Page: Enrollment Req (Only for roles which require CAQH based on contract’s compliance requirements)

Reason: The provider has not given their CAQH ID yet. Once the provider adds CAQH details then this alert will be removed automatically.

Alert: Pending CAQH rostering

Relevant Page: CAQH (Only for roles which require CAQH based on contract’s compliance requirements)

Reason: Provider has given CAQH IDs but they are not rostered under organization’s CAQH. Once a provider is added under the organization’s CAQH account then this alert will be removed automatically.

Alert: Pending CAQH review

Relevant Page: CAQH (Only for roles which require CAQH based on contract’s compliance requirements)

Reason: Provider has added data on CAQH and attested it on CAQH but their data is not reviewed/pulled to ConCred yet. If CAQH data is pulled into ConCred then this alert will be removed automatically.

Alert: Enrollment follow up due

Relevant Page: Enrollment

Reason: This alert appears on the follow up date set in the provider's enrollment page. This will be removed when the follow up reminder is dismissed.

Alert: Unverified compliance item(s)

Relevant Pages: Enrollment Req, Compliance Req

Reason: The provider has submitted the details but they are in ‘unverified state’. Once you verify it, this alert will be automatically removed.

Alert: Credentials expiring

Relevant Pages: Enrollment Req, Compliance Req

Reason: Provider has one or more compliance items which require renewal in 60 days or less. Once the provider adds the renewed details or this item is marked as ‘Not being added’ or when the expiry date is crossed then this alert will be removed automatically.

Alert: Credentials expired

Relevant Pages: Enrollment Req, Compliance Req

Reason: Provider’s one or more compliance items have expired. Once the provider adds the renewed details or this item is marked as ‘Not being added’ then this alert will be removed automatically.