Credentialing SOP
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      Request Onboarding for Special Credentialing Clients- Job Aid

      The below Job Aid presents instructions to assist the Credentialing Account Manager in creating a provider record in the secure credentialing portal

      The below Job Aid presents instructions to assist the Credentialing Account Manager in creating a provider record in the secure credentialing portal to load anything provided to them directly on a new provider added to a special credentialing contracted client. This will also provide step by step instructions on this and also on creation of a Hubspot ticket to engage the onboarding team. 

      A “Special” credentialing customer is one that has credentialing bundled in some manner. Usually RCM and Credentialing were sold as one fee (percentage or other). Rule of thumb is - if the customer does not pay for each provider being added then the contract is considered SPECIAL and the below would apply. Any add on provider or other service that goes through Deal Desk/ Sales is NOT to use this process below. If you have questions please see the credentialing team manager.

      Modio OneView Provider Creation

      When your “special” credentialing client reaches out to you (CAM/CSR) directly to add a provider you will need to enter the provider in our secure credentialing system. Before you begin you will need the following information to create the provider:

      • Provider full name

      • Provider Title

      • Provider Specialty

      • Providers Email Address

      Task #1 Create provider in Modio/ Oneview

       
      1

      Log into Modio and click on Team (if not your default landing page)
       
       

       
      2

      Click “+Add Provider”

      Using the above list of provider information you will create the provider, Click SAVE
       
       
      3

      Search Provider by name to locate them and click on the name to view profile.
       
       
      4

      From the provider profile, click on documents and click Upload. to attach anything sent to us by the client in this request.

      Task #2 Create Hubspot Credentialing Onboarding Ticket

       
      1

      From the company record in Hubspot click +add ticket.  

      • Ticket name: Credentialing + (doctors name or brief description of need)

      • Pipeline: Credentialing

      • Ticket Type: Credentialing

      • Description: brief description of ordered services.

      • Ticket Owner: Maria Arce

      • CREATE

      Attach Primary Contact: Add appropriate contact person from the practice that onboarding needs to work with to gather info.
       
       
       
       
      2

      Onboarding team will audit any attachments and send the email invitation to the client to enter and update Modio directly.

      Once audited profile shows all required documents and information was attached/ updated they will create the credentialing status ticket to notify CAM that the provider is ready for active creation & submission of apps for participation.

      Task #3 Merging New Credentialing Status Ticket with Existing Credentialing Status Ticket

       

      When you receive a new Credentialing Status ticket from Onboarding, this is their way to let you know this provider(s) is ready for work to begin.

      Auditing is completed and all documents and required information is now in the profile.

      Please take a moment to review and confirm that all required info is there so you are able to begin without issue.

       

      Document new ticket with existing Credentialing status ticket number. Add Note:

      i.e., Received ticket #1234567 to add new provider. please see existing credentialing status ticket #7654321 for all details going forward.

      Then close the new status ticket as “CS4-Eliminated”