CHILDREN FIRST MEDICAL GROUP, INC. CREDENTIALING DEPARTMENT FREQUENTLY ASKED QUESTIONS ***BayChildren’s Physicians Only*** Question: Why do I need to be credentialed with CFMG? Answer: CFMG is contracted with BayChildren’s Physicians to provide Credentialing and Contracting services. Question: How long does it take to be credentialed? Answer: Approximately 180 days. Question: How can I check the status of my credentialing application? Answer: Contact our Credentialing department. Teressa Mayfield 510-428-3527
[email protected] Philana Stearne 510-428-3885 x 4215
[email protected] Question: When can I see patients? Answer: Providers should not see patients prior to completion of the CFMG credentialing process. Question: What health plans am I participating with under CFMG? Answer: A list of the CFMG contracted health plans can be located on CHONet under CFMG Data http://192.168.1.59/chp1/template.cfm?id=95 Or contact our Contracting department:
[email protected] Question: When am I effective with the CFMG contracted health plans? Answer: Approximately 30 calendar days after the CFMG credentialing process is completed and/or your effective date with CFMG. Question: Answer:
After being credentialed, what if a CFMG contracted health plan does not have me listed with them after the 30 days? Contact our Provider Relations department. Susie Caso 510-428-3154
[email protected] Shawnderai Owens 510-428-3154
[email protected]
Question: How often do I need to be recredentialed? Answer: CFMG recredential their providers every 36 months.
(08/11/08)
CFMG Credentialing FAQs BayChildren’s
Question: When CFMG is delegated with a health plan, what does that mean? Answer: The responsibility of credentialing and recredentialing providers is given to CFMG. If CFMG is not delegated then the application goes to the health plan’s Credentialing department. Question: Answer:
What is a Council for Affordable Quality Healthcare (CAQH) application? An electronic process for completing credentialing applications.
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Do I need to complete the CAQH credentialing application? No, one of the services CFMG provides is the electronic completion of the CAQH application since the physicians information is in our database. CFMG will complete the CAQH application and forward a copy of the attestation page for the provider to sign.
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If I receive a credentialing application from a health plan, what should I do? Send it to CFMG’s Credentialing department. The Credentialing department will prepare the form and send to the physician to sign. The physician should sign and return the application to CFMG for mailing and tracking purposes.
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Question: How long does it takes to get a physician licensed in California? Answer: When all documents have been submitted to the Medical Board of California and an application is complete, regulations allow an 100 days for processing. See the Medical Board of California website http://www.medbd.ca.gov/applicant/Index.html Question: Can a physician see patients without a California Medical License? Answer: Absolutely not. Question: Answer:
Is there an interim license that can be used while the physician is getting certified in California? Not according to the Medical Board of California website http://www.medbd.ca.gov/applicant/Index.html
Question: Can an out of state physician get a Medi-Cal number? Answer: Not prior to receiving a California Medical License, and a California Drivers License. The California Medical License, and the California Drivers License are required documents for processing the Medi-Cal application.
(08/11/08)
CFMG Credentialing FAQs BayChildren’s
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When should CFMG be contacted if a new physician is being recruited from another state? At least 6 months in advance.
Question: How will practices know when a physician has been credentialed? Answer: A CFMG welcome letter is mailed to the physician’s practice address. CFMG post new physicians to the CFMG website, and we list new physicians in our quarterly newsletter. Question: If a physician is credentialed through the Medical Staff Office, does that speed up the time for the credentialing process with CFMG? Answer: No, the Medical Staff Office and the CFMG credentialing process is separate. The CFMG process is approximately 180 days after the application and supporting documents is returned. Question: When a physician already has a Medi-Cal number through another health care entity, can that same number be used? Answer: Yes, once a provider becomes a Medi-Cal rendering provider they do not need to re-apply. Medi-Cal is now using the NPI as their identifying number. Question: When the physician is trying to become participating with those health plans where CFMG is not delegated, how do they know that credentialing is completed. Answer: The health plan sends out a welcome letter. If CFMG get a copy then we will add to our website. Routinely we can query the health plan’s electronic directory to determine if new physicians have been loaded to their Provider Data Bases.
(08/11/08)
CFMG Credentialing FAQs BayChildren’s
