Understand the provider identifiers and profiles that must be clean before payer credentialing starts.
An NPI is the national identifier used in healthcare transactions. Therapists usually have an individual Type 1 NPI. A solo or group business may also need a Type 2 organizational NPI depending on how it contracts and bills.
CAQH is a provider data profile used by many payers during credentialing and directory maintenance. The profile needs clean license, education, work history, malpractice, practice location, disclosure, and attestation data.
The biggest issues are mismatched business names, old addresses, personal phone numbers, stale attestations, incomplete practice locations, and CAQH records that do not match payer applications.
Enroll in Bomi Billing for CAQH, payer applications, attestations, roster updates, and ongoing insurance billing. Credentialing is available only with Bomi Billing.
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